Provider Demographics
NPI:1326467119
Name:DUCHARME, LOUELLEN (RN)
Entity Type:Individual
Prefix:
First Name:LOUELLEN
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17829 HIGHWAY 9 S
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56514-9223
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1102 PAGE DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2300
Practice Address - Country:US
Practice Address - Phone:651-488-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR29197163WH0200X
MNR163478-9163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health