Individual
STEPHANIE RAE WALVATNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3887 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 427-8547
(763) 576-5394
Mailing address
3887 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2518
(763) 427-8547
(763) 576-5394
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R135327-7
MN
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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