Healthcare Provider Details

I. General information

NPI: 1598686644
Provider Name (Legal Business Name): MRS. AMBER DAWNN NIEUWSMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 HIGHWAY 49 S
BEULAH ND
58523-6725
US

IV. Provider business mailing address

4648 11TH ST SW
STANTON ND
58571-9463
US

V. Phone/Fax

Practice location:
  • Phone: 701-805-6827
  • Fax:
Mailing address:
  • Phone: 701-805-6827
  • Fax: 701-805-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1467
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: