Healthcare Provider Details

I. General information

NPI: 1811824774
Provider Name (Legal Business Name): KIRSTEN SCHUMACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 32ND AVE S
FARGO ND
58103-6132
US

IV. Provider business mailing address

4822 MEADOW CREEK DR S
FARGO ND
58104-7113
US

V. Phone/Fax

Practice location:
  • Phone: 701-364-8000
  • Fax:
Mailing address:
  • Phone: 701-367-0756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number20-0559-I
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: