Individual
CHRISTA NICOLE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2720 FAIRVIEW AVE N STE 100, SAINT PAUL, MN 55113-1306
(651) 241-5290
Mailing address
2720 FAIRVIEW AVE N STE 100, ROSEVILLE, MN 55113-1306
(651) 241-5290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11731
MN
363A00000X
Physician Assistant
3448
WI
Other
Enumeration date
11/17/2014
Last updated
03/28/2022
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