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General NPI Number Information
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NPI Number | 1811806037
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Entity Type | Individual
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Provider Name | MRS. BARBARA RUTH GUSTAFSON
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 361 26TH ST E
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City | DICKINSON
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State | ND
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Zip | 58601-6515
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Country | US
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Telephone | 701-456-1818
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Fax | 701-456-1820
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Provider Business Mailing Address
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Address Line | 1073 2ND ST E
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City | DICKINSON
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State | ND
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Zip | 58601-5414
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Country | US
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Telephone | 701-456-1818
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Fax | 701-456-1820
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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