Individual
MS. STEPHANIE RENAE NEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426
(952) 993-3282
Mailing address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3282
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10882
MN
Other
Enumeration date
03/14/2011
Last updated
07/20/2018
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