Provider Demographics
NPI:1073383824
Name:SUNDSETH, KRENDA JAY
Entity Type:Individual
Prefix:
First Name:KRENDA
Middle Name:JAY
Last Name:SUNDSETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRENDA
Other - Middle Name:JAY
Other - Last Name:ELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:HENDRUM
Mailing Address - State:MN
Mailing Address - Zip Code:56550-0175
Mailing Address - Country:US
Mailing Address - Phone:218-415-0397
Mailing Address - Fax:
Practice Address - Street 1:2822 7TH ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1452
Practice Address - Country:US
Practice Address - Phone:218-415-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care