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NPI Code Detail

MEDICARE: HOLLY MARY STENZEL TAYNTON D.O.

MEDICARE: HOLLY MARY STENZEL TAYNTON D.O.
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
1207Q00000XFamily Medicine Physician52380MN

General Provider Information

NPI Number : 1578725347
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY MARY STENZEL TAYNTON D.O.
Provider Business Mailing Address
First Line : 10760 55TH PL N
Second Line :
City : PLYMOUTH
State : MN
Zip : 55442-1930
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4209 WEBBER PKWY
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1747
Country : US
Telephone Number : 763-235-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2008
Last Update Date : 11/07/2011

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