Individual
STEPHANIE D GRAHEK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
797 - TEMP
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135331
UCARE
—
01
—
396G5GR FAC#6D053CE
BLUE CROSS BLUE SHIELD
—
01
—
991549
ARAZ GROUP AMERICAS PPO
—
01
—
HP40436
HEALTH PARTNERS
—
Enumeration date
10/25/2005
Last updated
03/07/2023
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