Anderson, Stacia R
Anderson, Stacia R is an individual health care provider with primary practice located at 146 Lake St N , Forest Lake MN 55025-2518. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Anderson, Stacia R can be contacted via phone (651) 464-8502.Contact Information
Primary practice address
146 Lake St N
Forest Lake MN 55025-2518
Phone: (651) 464-8502
Fax: (651) 464-8547
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4512 | Minnesota |
Profile Details
| NPI number | 1730297300 |
|---|---|
| LBN Legal business name | Anderson, Stacia R |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Aug 23rd, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730297300 | NPPES |
| Minnesota | Other | 195K5AN | BLUECROSS BLUESHIELD |
| Minnesota | Other | 6400629 | BLUECROSS BLUESHIELD |
| Minnesota | MEDICAID | 436322100 | BLUECROSS BLUESHIELD |
| Minnesota | Other | HP35860 | BLUECROSS BLUESHIELD |
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