Provider Demographics
NPI:1346994233
Name:KRABBENHOFT, ANNETTE ROBIN
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:ROBIN
Last Name:KRABBENHOFT
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58425-0334
Mailing Address - Country:US
Mailing Address - Phone:701-789-0947
Mailing Address - Fax:
Practice Address - Street 1:1104 LENHAM AVE SE
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:ND
Practice Address - Zip Code:58425
Practice Address - Country:US
Practice Address - Phone:701-789-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant