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General NPI Number Information
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NPI Number | 1588188692
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Entity Type | Individual
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Provider Name | ELIZABETH MARY STANEK DNP-FNP
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905
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Country | US
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Telephone | 507-284-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone | 507-284-2651
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07171259
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5320
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License Number State | MN
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