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NPI Code Detail

MEDICARE: JOSIE LYNN WUTZKE

MEDICARE:   JOSIE LYNN WUTZKE
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1861326985
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSIE LYNN WUTZKE
Provider Business Mailing Address
First Line : 1605 9TH AVE N
Second Line :
City : GRAND FORKS
State : ND
Zip : 58203-0711
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1605 9TH AVE N
Second Line :
City : GRAND FORKS
State : ND
Zip : 58203-0711
Country : US
Telephone Number : 701-732-1248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ JOSIE LYNN WUTZKE ” Practice Location

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