Individual
STEPHANIE S. MORUP
Active
Individual
STEPHANIE S. MORUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
377
MT
363AS0400X
Surgical Physician Assistant
Primary
MED-PAC-LIC-377
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000095613
BCBS PIN
MT
01
—
119944700
MDCD PIN
WY
01
—
4302974
MDCD PIN
MT
Enumeration date
09/20/2006
Last updated
12/14/2021
Update your record
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