Individual
STEPHANIE STACKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5520 BRISTOL LANE, MINNETONKA, MN 55343
(952) 938-0680
Mailing address
5520 BRISTOL LN, MINNETONKA, MN 55343-4306
(952) 938-0680
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
29886
MN
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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