Provider Demographics
NPI:1962139287
Name:DEWITZ, ERIN LYNN (DNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNN
Last Name:DEWITZ
Suffix:
Gender:F
Credentials:DNP
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 133
Mailing Address - Street 2:
Mailing Address - City:STEELE
Mailing Address - State:ND
Mailing Address - Zip Code:58482-0133
Mailing Address - Country:US
Mailing Address - Phone:701-361-5298
Mailing Address - Fax:
Practice Address - Street 1:3464 27TH AVE SE
Practice Address - Street 2:
Practice Address - City:STEELE
Practice Address - State:ND
Practice Address - Zip Code:58482-9424
Practice Address - Country:US
Practice Address - Phone:701-361-5298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDF06222098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily