Individual
MR. JOSEPH WALTER STEPHANIE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
55837 E HIGHWAY 55, BOX 121, PAYNESVILLE, MN 56362-9394
(320) 243-3908
Mailing address
55837 E HIGHWAY 55, BOX 121, PAYNESVILLE, MN 56362-9394
(320) 243-3908
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 063332-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R 063332-5
NURSING LICENSE
MN
Enumeration date
03/08/2006
Last updated
07/08/2007
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