Healthcare Provider Details

I. General information

NPI: 1841987534
Provider Name (Legal Business Name): ASHLEY CHRISTINE FANKHAUSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E 2ND ST
DULUTH MN
55805-1906
US

IV. Provider business mailing address

402 E 2ND ST
DULUTH MN
55805-1906
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-4626
  • Fax:
Mailing address:
  • Phone: 218-786-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number81788
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: