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General NPI Number Information
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NPI Number | 1003722794
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Entity Type | Organization
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Legal Business Name | PRAIRIE HEARTS HOME CARE LLC
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 3401 BAY SHORE BND SE
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City | MANDAN
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State | ND
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Zip | 58554-6260
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Country | US
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Telephone | 701-333-8187
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Fax | 701-333-8187
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Provider Business Mailing Address
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Address Line | 3401 BAY SHORE BND SE
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City | MANDAN
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State | ND
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Zip | 58554-6260
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Country | US
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Telephone | 701-333-8187
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Fax | 701-333-8187
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Authorized Official
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Title or Position | RN
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Name | AMY NELSON
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Credential | NELSON
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Telephone | 701-333-8187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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