Provider Demographics
NPI:1346058229
Name:RAMBERG, ELISE K (CNA)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:K
Last Name:RAMBERG
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 13TH AVE N APT 101
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-2063
Mailing Address - Country:US
Mailing Address - Phone:701-370-3579
Mailing Address - Fax:
Practice Address - Street 1:3800 13TH AVE N APT 101
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2063
Practice Address - Country:US
Practice Address - Phone:701-370-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND78123376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide