Staab, Beth Ann

Staab, Beth Ann is an individual health care provider with primary practice located at 11091 Ulysses St Suite 100, Blaine MN 55434. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Staab, Beth Ann can be contacted via phone (612) 879-1000.

Contact Information

Primary practice address
11091 Ulysses St Suite 100 Blaine MN 55434
Phone: (612) 879-1000
Fax: (612) 879-9116
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 002152 Georgia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 53994 Minnesota

Profile Details

NPI number 1295911238
LBN Legal business name Staab, Beth Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2008
Last updated Sep 13th, 2011 - about 15 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 1295911238 NPPES
Georgia Other 002152 STATE

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