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General NPI Number Information
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NPI Number | 1700740347
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Entity Type | Individual
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Provider Name | KELSIE LYNN LAIZURE
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 220 CENTRAL AVE N APT 9
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City | VALLEY CITY
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State | ND
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Zip | 58072-2946
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Country | US
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Telephone | 701-561-8178
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Fax |
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Provider Business Mailing Address
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Address Line | 220 CENTRAL AVE N APT 4
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City | VALLEY CITY
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State | ND
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Zip | 58072-2946
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Country | US
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Telephone | 701-840-0620
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | KLI889774
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number | KLI889774
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License Number State | ND
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