Doctor Name: | DR. LAUREL ANN DIMLER |
NPI Number: | 1386028942 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP, NP-C |
License Number: | R25080 |
Business Practice Address: | 4102 Bay Ave Lot 3 Garrison, ND - 585409415 |
Business Phone Number: | 7013372167 |
Business Fax Number: | |
Mailing Address: | 4102 Bay Ave Lot E, GARRISON |
State: | ND |
Postal Code: | 585409415 |
Phone Number: | 7013372167 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2015 |
NPI Last Update Date: | 07/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R25080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |