Individual
STACY J ZIMNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
211 E MILL ST, PELICAN RAPIDS, MN 56572
(218) 863-6100
(218) 863-6173
Mailing address
211 E MILL ST, PO BOX 737, PELICAN RAPIDS, MN 56572
(218) 863-6100
(218) 863-6173
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9966
MN
363AM0700X
Medical Physician Assistant
9966
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483903000
—
MN
05
—
71194
—
ND
Enumeration date
07/22/2006
Last updated
04/15/2024
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