Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 41031 | MN |
NPI | 1003893066 |
---|---|
Provider Name | Dr. Stacy L Noyes |
First Address | Blaine, MN 55434-3947 |
Second Address | Blaine, MN 55434-3947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 27/04/2012 |