Individual
PENNY JEAN STADICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHP,CCAP, CNC, CH
Contact information
Practice address
420 6TH ST W, WEST FARGO, ND 58078-1532
(480) 766-2716
Mailing address
420 6TH ST W, WEST FARGO, ND 58078-1532
(480) 766-2716
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
171400000X
Health & Wellness Coach
Primary
—
—
174H00000X
Health Educator
—
—
176B00000X
Midwife
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374J00000X
Doula
—
—
Other
Enumeration date
04/30/2020
Last updated
07/19/2021
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