Individual provider · NPI-1

Carl Charley

Home Health Aide · Fargo, ND

NPI number1811779127
StatusActive
Last updated in NPPESOct 20, 2023

Details

NPI
1811779127
Entity type
Individual (NPI-1)
Name
Carl Charley
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 20, 2023
Certification date
Oct 20, 2023
Last updated
Oct 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes

Practice location

1141 18th St N
Fargo, ND 58102-3215

Phone 701-936-1152

Mailing address

1141 18th St N
Fargo, ND 58102-3215

Phone 701-936-1152

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