Healthcare Provider Details

I. General information

NPI: 1265352603
Provider Name (Legal Business Name): KATHLEEN BENNETT ZAUN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 6TH AVE SW
VALLEY CITY ND
58072-3223
US

IV. Provider business mailing address

107 6TH AVE SW
VALLEY CITY ND
58072-3223
US

V. Phone/Fax

Practice location:
  • Phone: 701-306-3811
  • Fax:
Mailing address:
  • Phone: 701-306-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: