MEDICARE: RHONDA LAURICE HUOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife

General Provider Information

NPI Number	:	1295324143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LAURICE HUOT

Provider Business Mailing Address
First Line	:	23769 425TH AVE SW
Second Line	:
City	:	EAST GRAND FORKS
State	:	MN
Zip	:	56721-9625
Country	:	US
Telephone Number	:	218-779-5826
Fax Number	:

Provider Business Practice Location Address
First Line	:	23769 425TH AVE SW
Second Line	:
City	:	EAST GRAND FORKS
State	:	MN
Zip	:	56721-9625
Country	:	US
Telephone Number	:	218-779-5826
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	01/14/2021

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Directions to “ RHONDA LAURICE HUOT ” Practice Location

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