Healthcare Provider Details

I. General information

NPI: 1558287987
Provider Name (Legal Business Name): ASHLEY LUTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 MAIN ST
CARRINGTON ND
58421-2024
US

IV. Provider business mailing address

990 MAIN ST
CARRINGTON ND
58421-2024
US

V. Phone/Fax

Practice location:
  • Phone: 701-652-2651
  • Fax: 701-652-1882
Mailing address:
  • Phone: 701-652-2651
  • Fax: 701-652-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: