Provider Demographics
NPI:1568275949
Name:KPUE, PATRICIA (CNA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:KPUE
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 1:5170 AMBER VALLEY PKWY S APT 114
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8607
Mailing Address - Country:US
Mailing Address - Phone:301-364-7355
Mailing Address - Fax:
Practice Address - Street 1:5170 AMBER VALLEY PKWY S APT 114
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8607
Practice Address - Country:US
Practice Address - Phone:301-364-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant