Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | R41443 | ND |
NPI | 1043822455 |
---|---|
Provider Name | Erin Eliza Lubitz |
First Address | Fargo, ND 58104-9140 |
Second Address | Fargo, ND 58104-9140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2020 |
Last Update Date | 23/08/2021 |