Individual
MARY STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
601 JACOB LN, ANOKA, MN 55303-1776
(763) 587-4200
(763) 587-4205
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
5190
MN
Other
Enumeration date
05/22/2018
Last updated
10/05/2021
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