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General NPI Number Information
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NPI Number | 1740573757
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Entity Type | Individual
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Provider Name | OLGA KONDRATYUK
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Gender | Female
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 1579 S LAKE CREST WAY
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City | EAGLE
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State | ID
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Zip | 83616-7141
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Country | US
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Telephone | 208-250-6583
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Fax | 208-639-6298
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Provider Business Mailing Address
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Address Line | 1579 S LAKE CREST WAY
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City | EAGLE
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State | ID
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Zip | 83616-7141
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Country | US
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Telephone | 208-250-6583
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Fax | 208-639-6298
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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 | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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