Healthcare Provider Details

I. General information

NPI: 1710892146
Provider Name (Legal Business Name): ERIN CONSTANCE DUMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 BROADWAY N
FARGO ND
58102-1420
US

IV. Provider business mailing address

2800 BROADWAY N
FARGO ND
58102-1420
US

V. Phone/Fax

Practice location:
  • Phone: 701-293-0221
  • Fax: 701-241-7944
Mailing address:
  • Phone: 701-293-0221
  • Fax: 701-241-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number46708
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: