Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 59366 | MN |
Y | 207VX0201X | Gynecologic Oncologist | 59366 | MN |
NPI | 1538575626 |
---|---|
Provider Name | Dr. Stephanie Dejong |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 21/07/2021 |