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Individual

ROSE STAHLECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
420 SOUTH 7TH STREET, OAKES, ND 58474-2024
(701) 742-3267
(701) 742-3201
Mailing address
PO BOX 50, OAKES, ND 58474-0050
(701) 742-3267
(701) 742-3201

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0100
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18133
BLUE SHIELD
ND
01
18134
BLUE SHIELD
ND
01
19187
BLUE SHIELD
ND
01
19188
BLUE SHIELD
ND
01
25977
BLUE SHIELD
ND
01
28585
BLUE SHIELD
ND
01
28586
BLUE SHIELD
ND
01
970009835
TRAVELERS MEDICARE
Enumeration date
10/19/2005
Last updated
05/21/2008
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