Provider Demographics
NPI:1043931892
Name:ENLIGHTEN HEALTHCARE PLLC
Entity Type:Organization
Organization Name:ENLIGHTEN HEALTHCARE PLLC
Other - Org Name:ENLIGHTEN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:AUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-400-3167
Mailing Address - Street 1:1925 LOVETT AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-6736
Mailing Address - Country:US
Mailing Address - Phone:701-540-9801
Mailing Address - Fax:701-394-5317
Practice Address - Street 1:1925 LOVETT AVE STE 5
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-6736
Practice Address - Country:US
Practice Address - Phone:701-540-9801
Practice Address - Fax:701-394-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty