Healthcare Provider Details

I. General information

NPI: 1790779197
Provider Name (Legal Business Name): STEPHANIE F. BUCKMIER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE F. TWETEN NP-C

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 HIGHWAY 2 E
RUGBY ND
58368-7801
US

IV. Provider business mailing address

301 ROOSEVELT AVE
MADDOCK ND
58348-7138
US

V. Phone/Fax

Practice location:
  • Phone: 701-776-5455
  • Fax: 701-776-7023
Mailing address:
  • Phone: 701-438-2555
  • Fax: 701-438-2551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR28617
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: