Provider Demographics
NPI:1609093103
Name:BYFUGLIEN, VANGIEVAIL JEAN
Entity Type:Individual
Prefix:
First Name:VANGIEVAIL
Middle Name:JEAN
Last Name:BYFUGLIEN
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 1:35613 COUNTY ROAD 16
Mailing Address - Street 2:
Mailing Address - City:ROSEAU
Mailing Address - State:MN
Mailing Address - Zip Code:56751-8226
Mailing Address - Country:US
Mailing Address - Phone:218-469-0890
Mailing Address - Fax:
Practice Address - Street 1:35613 COUNTY ROAD 16
Practice Address - Street 2:
Practice Address - City:ROSEAU
Practice Address - State:MN
Practice Address - Zip Code:56751-8226
Practice Address - Country:US
Practice Address - Phone:218-469-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR29973163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health