Cederstrom, Stacy Ann

Cederstrom, Stacy Ann is an individual health care provider with primary practice located at 425 7Th Street North East , Cass Lake MN 56633. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Cederstrom, Stacy Ann can be contacted via phone (218) 335-3200.

Contact Information

Primary practice address
425 7Th Street North East Cass Lake MN 56633
Phone: (218) 335-3200
Fax: (218) 335-3300
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4566 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP4566 Minnesota

Profile Details

NPI number 1174079917
LBN Legal business name Cederstrom, Stacy Ann
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2016
Last updated May 22nd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174079917 NPPES
Minnesota Other CNP4566 FNP LICENSE
Minnesota Other MC3911028 FNP LICENSE

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