Provider Demographics
NPI:1689272361
Name:ARLIEN, CAROLYN
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ARLIEN
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 1:2528 123RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ANETA
Mailing Address - State:ND
Mailing Address - Zip Code:58212-9245
Mailing Address - Country:US
Mailing Address - Phone:701-230-5120
Mailing Address - Fax:
Practice Address - Street 1:7332 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-8835
Practice Address - Country:US
Practice Address - Phone:701-393-4461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant