Provider Demographics
NPI:1437972007
Name:AZURE, NICOLE RAE
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:RAE
Last Name:AZURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1180
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-1180
Mailing Address - Country:US
Mailing Address - Phone:218-207-1629
Mailing Address - Fax:
Practice Address - Street 1:3337 BIA ROAD 6
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329-9307
Practice Address - Country:US
Practice Address - Phone:701-244-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide