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SHASTA MANDAN R.N., C.D.E.
NPI 1386092203
Registered Nurse - Diabetes Educator in New Town, ND

Active since June 01, 2016
1058 COLLEGE DR, NEW TOWN, ND 58763(701) 627-7931 Get Directions Write a Review

NPPES record last updated: June 1, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shasta Mandan R.n., C.d.e. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA MANDAN R.N., C.D.E. (NPI 1386092203) is an individual diabetes educator provider in New Town, North Dakota, licensed in North Dakota (R29464) and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1386092203
Entity TypeIndividualFemale
Primary Taxonomy163WD0400X
Provider Legal NameSHASTA MANDANCredential: R.N., C.D.E.
Location Address1058 COLLEGE DRNew Town, ND 58763-9112
Mailing Address1058 College DrNew Town, ND 58763-9112 · (701) 627-7931
Phone(701) 627-7931
Sole ProprietorNo
Enumeration DateJune 1, 2016
✔ NPI 1386092203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Diabetes EducatorNursing Service Providers
Taxonomy Code163WD0400X
License✔ Licensed in ND · R29464
1058 COLLEGE DR, New Town, ND 58763
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMIE THONGPHET FNP-BC
Nurse Practitioner (Family)
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
DR. SAMUEL STUART JOHNSON M.D.
Family Medicine
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
JOANNE WIERSON RN
Registered Nurse
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
CRYSTAL SNOE RN
Registered Nurse
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
ELBOWOODS MEMORIAL HEALTH CENTER
Nurse Practitioner
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
ELBOWOODS MEMORIAL HEALTH CENTER
Optometrist
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-4750
ELBOWOODS MEMORIAL HEALTH CENTER
Physician Assistant
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (710) 627-4750
DOUGLAS MAI
Radiology (Diagnostic Radiology)
1058 COLLEGE DR
NEW TOWN, ND 58763
Mountrail County (701) 627-7681

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shasta Mandan's NPI number?

The NPI number for Shasta Mandan is 1386092203. It was assigned to this individual provider in the NPPES registry on June 1, 2016.

Where is Shasta Mandan located?

Shasta Mandan practices at 1058 College Dr, New Town, ND 58763. The listed phone number is (701) 627-7931.

What is Shasta Mandan's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Diabetes Educator, with taxonomy code 163WD0400X.

When was this NPI record last updated?

The NPPES record for Shasta Mandan was last updated on June 1, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.