Provider Demographics
NPI:1679700595
Name:DUERRE, RACHELLE BREANN
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:BREANN
Last Name:DUERRE
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 1:600 SOUTH MAIN ST.
Mailing Address - Street 2:MANORCARE HEALTH SERVICES
Mailing Address - City:MINOT ND
Mailing Address - State:ND
Mailing Address - Zip Code:58701
Mailing Address - Country:US
Mailing Address - Phone:701-338-2072
Mailing Address - Fax:701-338-2031
Practice Address - Street 1:300 MAIN ST S
Practice Address - Street 2:SOURIS VALLEY CARE CENTER
Practice Address - City:VELVA
Practice Address - State:ND
Practice Address - Zip Code:58790-7342
Practice Address - Country:US
Practice Address - Phone:701-338-2072
Practice Address - Fax:701-338-2031
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist