Healthcare Provider Details

I. General information

NPI: 1457144362
Provider Name (Legal Business Name): ERIN HELEN ERIN DAVIDHEISER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date: 06/03/2025
Reactivation Date: 08/05/2025

III. Provider practice location address

1016 ENTERPRISE AVE APT 1
DICKINSON ND
58601-4172
US

IV. Provider business mailing address

1701 ABRAHAM PKWY UNIT 7 APT 7
DICKINSON ND
58601-5592
US

V. Phone/Fax

Practice location:
  • Phone: 701-504-8032
  • Fax:
Mailing address:
  • Phone: 701-502-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberNDL154059
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: