MEDICARE: SIERRA CHRISTINA STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	2023-00447	MN

General Provider Information

NPI Number	:	1164298063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA CHRISTINA STONE

Provider Business Mailing Address
First Line	:	3096 RIDGEWOOD RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55112-3650
Country	:	US
Telephone Number	:	612-396-6410
Fax Number	:

Provider Business Practice Location Address
First Line	:	3096 RIDGEWOOD RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55112-3650
Country	:	US
Telephone Number	:	612-396-6410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	11/30/2023

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Directions to “ SIERRA CHRISTINA STONE ” Practice Location

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