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General NPI Number Information
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NPI Number | 1184102329
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Entity Type | Individual
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Provider Name | KAYLA LYNN BACHAND NP
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 4141 31ST AVE S STE 105
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City | FARGO
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State | ND
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Zip | 58104-8778
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Country | US
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Telephone | 701-314-4008
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Fax | 701-829-7247
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Provider Business Mailing Address
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Address Line | 1328 35TH AVE S
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City | MOORHEAD
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State | MN
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Zip | 56560-5134
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Country | US
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Telephone | 320-760-8064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R39003
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License Number State | ND
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