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General NPI Number Information
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NPI Number | 1821743667
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Entity Type | Individual
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Provider Name | KOBE MCKAY
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Gender | Male
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 305 2ND AVENUE S
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City | HAMPDEN
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State | ND
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Zip | 58338-5833
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Country | US
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Telephone | 701-381-9752
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | HAMPDEN
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State | ND
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Zip | 58338-0123
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Country | US
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Telephone | 701-381-9752
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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