NPI Profile for STACEY D PETERSON in MINOT, ND.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1073207569 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/07/2023 | |
| Last updated | 09/24/2025 - About 8 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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STACEY D PETERSON
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