Healthcare Provider Details

I. General information

NPI: 1366992661
Provider Name (Legal Business Name): SHARI LUNDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 1ST ST SW STE 201
MINOT ND
58701-3877
US

IV. Provider business mailing address

1015 S BROADWAY SUITE 18
MINOT ND
58701-4667
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-0836
  • Fax: 701-852-0623
Mailing address:
  • Phone: 701-857-8500
  • Fax: 701-857-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5486
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: