Healthcare Provider Details

I. General information

NPI: 1134663685
Provider Name (Legal Business Name): PATRICIA STEGEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2016
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRACARE CIR #2500
SAINT CLOUD MN
56303-5000
US

IV. Provider business mailing address

1900 CENTRACARE CIRCLE #2500
SAINT CLOUD MN
56303-5000
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-5000
  • Fax: 320-229-5184
Mailing address:
  • Phone: 320-229-5000
  • Fax: 320-229-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR094500-0
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: