Rose Michelle Burcham-Lafountain

Individual provider Active NPI Personal Care Attendant · Mandan, ND

NPI 1831860113 · NPPES record last updated Sep 25, 2021

Key facts

NPI
1831860113
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
69350 (ND)
Practice address
1010 1St St SE Lot 19
Mandan, ND 58554-4481
Phone
(701) 550-9854
NPI assigned
Sep 25, 2021
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

State licenses

LicenseStateTypeSpecialty
69350NDMDPersonal Care Attendant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 69350 ND Yes

Addresses

Primary practice location

1010 1St St SE Lot 19
Mandan, ND 58554-4481

Mailing address

PO Box 904
Mandan, ND 58554-0904
Phone (701) 550-9854

Other providers in Mandan, ND

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

Sources for this page

Verify at the official NPI Registry.