Provider Demographics
NPI:1174400659
Name:WHITESHIELD, BERNADINE
Entity type:Individual
Prefix:
First Name:BERNADINE
Middle Name:
Last Name:WHITESHIELD
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 221
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:ND
Mailing Address - Zip Code:58370-0221
Mailing Address - Country:US
Mailing Address - Phone:701-230-2852
Mailing Address - Fax:
Practice Address - Street 1:1015 BELLILE ST UNIT 401
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:ND
Practice Address - Zip Code:58370-7008
Practice Address - Country:US
Practice Address - Phone:701-230-2852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant