Healthcare Provider Details

I. General information

NPI: 1912843103
Provider Name (Legal Business Name): PATRICE ANN STAMPS PIECZYNSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICE ANN STAMPS

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5621 COUNTY ROAD 101
MINNETONKA MN
55345-4214
US

IV. Provider business mailing address

15461 W SUNRISE CIR
EDEN PRAIRIE MN
55347-2544
US

V. Phone/Fax

Practice location:
  • Phone: 952-401-5992
  • Fax:
Mailing address:
  • Phone: 507-995-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR-1242553
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: