Provider Demographics
NPI:1932919370
Name:DESAUTEL, ASHLEY KATE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KATE
Last Name:DESAUTEL
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 1:5011 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-1853
Mailing Address - Country:US
Mailing Address - Phone:701-215-2260
Mailing Address - Fax:
Practice Address - Street 1:1550 9TH AVE S APT 4
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4202
Practice Address - Country:US
Practice Address - Phone:701-740-5015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant