Healthcare Provider Details

I. General information

NPI: 1821797895
Provider Name (Legal Business Name): KATIA KJELLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6648 128TH AVE NE
PARK RIVER ND
58270-9618
US

IV. Provider business mailing address

6648 128TH AVE NE
PARK RIVER ND
58270-9618
US

V. Phone/Fax

Practice location:
  • Phone: 701-566-2414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: