Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 102696 | MN |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2479 | MN |
NPI | 1013013424 |
---|---|
Provider Name | Heather Emily Stefanski |
First Address | Saint Paul, MN 55117-3358 |
Second Address | Minneapolis, MN 55455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 03/01/2012 |