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General NPI Number Information
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NPI Number | 1912155763
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Entity Type | Individual
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Provider Name | STEPHANIE L HEMMER D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 1520 WHITNEY COURT, SUITE 200 MIO MN FAMILY MEDICINE CENTER
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City | SAINT COULD
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State | MN
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Zip | 56303-1867
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Country | US
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Telephone | 320-240-3157
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Fax | 320-240-3164
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Provider Business Mailing Address
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Address Line | 1520 WHITNEY COURT, SUITE 200 MIO MN FAMILY MEDICINE CENTER
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City | SAINT COULD
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State | MN
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Zip | 56303-1867
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Country | US
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Telephone | 320-240-3157
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Fax | 320-240-3164
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21023
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License Number State | MN
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