MEDICARE: JOSIANNA MABEL PROCHNOW CNA

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1770229684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSIANNA MABEL PROCHNOW CNA

Provider Business Mailing Address
First Line	:	9987 170TH AVE SE
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-9776
Country	:	US
Telephone Number	:	701-899-2941
Fax Number	:

Provider Business Practice Location Address
First Line	:	9470 COUNTY ROAD 1
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041-9744
Country	:	US
Telephone Number	:	701-242-7831
Fax Number	:

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

Provider Enumeration Date	:	05/12/2022
Last Update Date	:	05/12/2022

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Directions to “ JOSIANNA MABEL PROCHNOW CNA” Practice Location

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