Healthcare Provider Details

I. General information

NPI: 1558284281
Provider Name (Legal Business Name): SHARI TIMMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7448 68TH AVE NE
CANDO ND
58324-9485
US

IV. Provider business mailing address

101 E BROADWAY AVE
BISMARCK ND
58501-3840
US

V. Phone/Fax

Practice location:
  • Phone: 701-222-0386
  • Fax: 701-291-8456
Mailing address:
  • Phone: 701-222-0386
  • Fax: 701-291-8456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: