Individual
ERIN LEE DICIOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN, PMHNP-BC
Contact information
Practice address
1112 NODAK DR S, FARGO, ND 58103-2333
(701) 232-6224
(701) 232-4687
Mailing address
625 W BRYANT APT 106, SPRINGFIELD, MO 65810-8337
(218) 689-0412
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2024030370
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R51586
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1492310
—
ND
05
—
334022758
—
AR
05
—
420145421
—
MO
Enumeration date
08/14/2023
Last updated
08/25/2025
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