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General NPI Number Information
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NPI Number | 1588055842
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Entity Type | Individual
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Provider Name | STEPHANIE CHRISTINE HOLTHUS
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Gender | Female
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1833 W US HIGHWAY 2 # G
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-4736
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Country | US
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Telephone | 507-469-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 10075 S GULL LAKE RD NE
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City | TENSTRIKE
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State | MN
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Zip | 56683-2083
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Country | US
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Telephone | 507-469-2545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 1107
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License Number State | MN
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