Individual
STEPHANIE DAVISON IANNAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
103806
MN
207L00000X
Anesthesiology Physician
45349
AZ
207L00000X
Anesthesiology Physician
Primary
51086
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20377
RESIDENT PERMIT
MN
05
—
35339700
—
WI
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
05/07/2008
Last updated
12/04/2012
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