| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Two Eagle, Tiffaney | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1235650250 | [sources] | |||
| Sector | Registered Nurse 29206 | [sources] | |||
| Status | not available | [sources] | |||
| Address | 4179 81st Ave NE St. Michael, ND 58370 | [sources] | |||
| Last change | Last processed | First seen | |||
This dataset contains a list of providers who have been terminated for cause from North Dakota's Medicaid program.
United States of America · NDHHS
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