Provider Demographics
NPI:1932364650
Name:LEE, ERIN E (NP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:DHUYVETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 HARWOOD DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4603
Mailing Address - Country:US
Mailing Address - Phone:701-234-2700
Mailing Address - Fax:701-234-2783
Practice Address - Street 1:1111 HARWOOD DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4603
Practice Address - Country:US
Practice Address - Phone:701-234-2700
Practice Address - Fax:701-234-2783
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR29659363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner