Healthcare Provider Details

I. General information

NPI: 1073458543
Provider Name (Legal Business Name): DANA RAE PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANA HIX

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 32ND ST E APT 104
WILLISTON ND
58801-5065
US

IV. Provider business mailing address

321 32ND ST E APT 104
WILLISTON ND
58801-5065
US

V. Phone/Fax

Practice location:
  • Phone: 701-978-4369
  • Fax:
Mailing address:
  • Phone: 701-978-4369
  • 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: