Jacqueline L Bauerle, CPHT, CNA

Individual provider Active NPI Personal Care Attendant · Harvey, ND

NPI 1336747641 · NPPES record last updated Oct 9, 2020

Key facts

NPI
1336747641
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
2650 32ND Ave NE Apt 1
Harvey, ND 58341-8604
Phone
(701) 341-7476
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

2650 32ND Ave NE Apt 1
Harvey, ND 58341-8604

Mailing address

2650 32ND Ave NE
Harvey, ND 58341-8604
Phone (170) 134-1747

Other identifiers

IdentifierTypeStateIssuer
16373OtherNDCERTIFIED NURSING ASSISTANT
1451384MedicaidND
10014274OtherNDPHARMACY TECHNICIAN CERTIFICATION BOARD

Other providers in Harvey, ND

All providers in Harvey, ND · Personal Care Attendant in North Dakota

Sources for this page

Verify at the official NPI Registry.