Provider Demographics
NPI:1750989935
Name:HYBSHA, NDAIZIWEYI
Entity type:Individual
Prefix:
First Name:NDAIZIWEYI
Middle Name:
Last Name:HYBSHA
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 1:2029 KOCH DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1240
Mailing Address - Country:US
Mailing Address - Phone:701-319-9526
Mailing Address - Fax:
Practice Address - Street 1:300 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-4013
Practice Address - Country:US
Practice Address - Phone:701-663-6252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant