Healthcare Provider Details

I. General information

NPI: 1811065766
Provider Name (Legal Business Name): ERIN K HAGEMEISTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 LINCOLN AVE
HARVEY ND
58341-1524
US

IV. Provider business mailing address

317 1ST AVE NW PO BOX 697
KENMARE ND
58746-7104
US

V. Phone/Fax

Practice location:
  • Phone: 701-324-4856
  • Fax: 701-324-4858
Mailing address:
  • Phone: 701-385-4344
  • Fax: 701-385-4295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR28260
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: