Healthcare Provider Details

I. General information

NPI: 1083594402
Provider Name (Legal Business Name): STEPHANIE SARAZINE PMHNP-BC, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13045 FALCON DR STE 100
BAXTER MN
56425-4201
US

IV. Provider business mailing address

824 13TH AVE S
SAINT CLOUD MN
56301-5223
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-9307
  • Fax:
Mailing address:
  • Phone: 763-607-3277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13330
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: