MEDICARE: SHARON ELIZABETH WHITMER RN-CDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R19624	ND
2	163WD0400X	Diabetes Educator Registered Nurse	2222-0541	ND

General Provider Information

NPI Number	:	1760497523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON ELIZABETH WHITMER RN-CDE

Provider Business Mailing Address
First Line	:	PO BOX 309
Second Line	:	3883 74TH AVE. NE
City	:	FORT TOTTEN
State	:	ND
Zip	:	58335-0309
Country	:	US
Telephone Number	:	701-766-1624
Fax Number	:

Provider Business Practice Location Address
First Line	:	3883 74TH AVE. NE
Second Line	:
City	:	FORT TOTTEN
State	:	ND
Zip	:	58335-0309
Country	:	US
Telephone Number	:	701-766-1624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/11/2025

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