Healthcare Provider Details

I. General information

NPI: 1568367837
Provider Name (Legal Business Name): SIXVARA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S MAIN AVE
RUGBY ND
58368-2124
US

IV. Provider business mailing address

502 S MAIN AVE
RUGBY ND
58368-2124
US

V. Phone/Fax

Practice location:
  • Phone: 701-425-1258
  • Fax:
Mailing address:
  • Phone: 701-425-1258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA MCKNIGHT
Title or Position: OWNER
Credential:
Phone: 701-425-1258