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NPI Code Detail

MEDICARE: LESA RENAE STEGNER MSN

MEDICARE: LESA RENAE STEGNER MSN
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
1363LF0000XFamily Nurse PractitionerR1411766MN

General Provider Information

NPI Number : 1205820719
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESA RENAE STEGNER MSN
Provider Business Mailing Address
First Line : 22542 HAYWARD AVE N
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-8560
Country : US
Telephone Number : 651-398-5517
Fax Number :
Provider Business Practice Location Address
First Line : 900 NICOLLET MALL
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55403-2530
Country : US
Telephone Number : 612-659-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 01/30/2009

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