Martin, Stephanie Lynn

Martin, Stephanie Lynn is an individual health care provider with primary practice located at 1185 Town Centre Dr Ste 205 , Eagan MN 55123-1370. 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. Martin, Stephanie Lynn can be contacted via phone (612) 871-1145.

Contact Information

Primary practice address
1185 Town Centre Dr Ste 205 Eagan MN 55123-1370
Phone: (612) 871-1145
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4669-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 13826 Minnesota

Profile Details

NPI number 1790340552
LBN Legal business name Martin, Stephanie Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2019
Last updated Oct 28th, 2021 - about 5 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 1790340552 NPPES
Wisconsin MEDICAID 1790340552

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