Individual
SUSAN MARIE STAVRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
50 10TH AVE S, WAITE PARK, MN 56387-1055
(320) 230-9939
(320) 230-9941
Mailing address
50 10TH AVE S, WAITE PARK, MN 56387-1055
(320) 230-9939
(320) 230-9941
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
R67936-3
MN
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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