Provider Demographics
NPI:1396343547
Name:DEMERS, EILEEN
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:DEMERS
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 1:425 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1251
Mailing Address - Country:US
Mailing Address - Phone:701-520-1297
Mailing Address - Fax:
Practice Address - Street 1:455 E 5TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1507
Practice Address - Country:US
Practice Address - Phone:701-360-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant