Individual
STACY ANN CEDERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
425 7TH STREET NORTH EAST, CASS LAKE, MN 56633
(218) 335-3200
(218) 335-3300
Mailing address
425 7TH STREET NORTH EAST, CASS LAKE, MN 56633
(218) 335-3200
(218) 335-3300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4566
MN
363LF0000X
Family Nurse Practitioner
Primary
CNP4566
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP4566
FNP LICENSE
MN
01
—
MC3911028
DNP
MN
Enumeration date
08/31/2016
Last updated
05/22/2023
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