Konzak, Stacey Lee

Konzak, Stacey Lee is an individual health care provider with primary practice located at 2900 E Broadway Ave , Bismarck ND 58501-5112. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Konzak, Stacey Lee can be contacted via phone (701) 221-9997.

Contact Information

Primary practice address
2900 E Broadway Ave Bismarck ND 58501-5112
Phone: (701) 221-9997
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0537 South Dakota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PAC0348 North Dakota

Profile Details

NPI number 1962486969
LBN Legal business name Konzak, Stacey Lee
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Sep 18th, 2014 - about 10 years ago

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 1962486969 NPPES
South Dakota MEDICAID 6825030
South Dakota MEDICAID 71237

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