Individual
SUSAN L STABO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1300 HOSPITAL LOOP, BELCOURT, ND 58316-0160
(701) 477-6111
Mailing address
PO BOX 160, BELCOURT, ND 58316-0160
(701) 477-6111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R26722
ND
363LF0000X
Family Nurse Practitioner
R26722
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19807
—
ND
05
—
717610400
—
MN
Enumeration date
10/11/2006
Last updated
04/25/2025
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