Individual
STACEY L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
7250 FRANCE AVE S, SUITE # 415, EDINA, MN 55435-4305
(952) 926-3566
(952) 929-3358
Mailing address
7250 FRANCE AVE S, SUITE # 415, EDINA, MN 55435-4305
(952) 926-3566
(952) 929-3358
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
595
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
595
PODIATRIC LICENSE
MN
Enumeration date
07/21/2005
Last updated
09/18/2013
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