Healthcare Provider Details

I. General information

NPI: 1760497523
Provider Name (Legal Business Name): SHARON ELIZABETH WHITMER RN-CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 74TH AVE. NE
FORT TOTTEN ND
58335-0309
US

IV. Provider business mailing address

PO BOX 309 3883 74TH AVE. NE
FORT TOTTEN ND
58335-0309
US

V. Phone/Fax

Practice location:
  • Phone: 701-766-1624
  • Fax:
Mailing address:
  • Phone: 701-766-1624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR19624
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2222-0541
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: