Individual
DOLORES I VAN BOURGONDIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
3674 S WASHINGTON ST, GRAND FORKS, ND 58201-5766
(701) 205-3000
(701) 732-2501
Mailing address
PO BOX 5210, GRAND FORKS, ND 58206-5210
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP9239798
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R54243
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010140700
—
FL
05
—
1695195
—
AK
Enumeration date
10/10/2013
Last updated
01/27/2026
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