Provider Demographics
NPI:1386364909
Name:KOBRIGER, RENAE MARIE
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:MARIE
Last Name:KOBRIGER
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 1:102 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:RICHARDTON
Mailing Address - State:ND
Mailing Address - Zip Code:58652-7007
Mailing Address - Country:US
Mailing Address - Phone:701-690-2209
Mailing Address - Fax:
Practice Address - Street 1:102 3RD AVE E
Practice Address - Street 2:
Practice Address - City:RICHARDTON
Practice Address - State:ND
Practice Address - Zip Code:58652-7007
Practice Address - Country:US
Practice Address - Phone:701-690-2209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty