Healthcare Provider Details

I. General information

NPI: 1245276930
Provider Name (Legal Business Name): KRISTI J STEMSRUD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FLYNN DR
MILBANK SD
57252
US

IV. Provider business mailing address

301 FLYNN DR
MILBANK SD
57252
US

V. Phone/Fax

Practice location:
  • Phone: 605-432-4587
  • Fax:
Mailing address:
  • Phone: 605-432-4587
  • Fax: 605-328-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11982
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0332
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2338
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: