Individual
STEPHANIE I BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
(701) 237-2680
Mailing address
PO BOX 442, HAWLEY, MN 56549-0442
(218) 790-2696
Taxonomy
Speciality
Code
Description
License number
State
246RH0600X
Histology Technician
Primary
25604048
ND
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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