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Contact Information

STACEY D PETERSON
400 BURDICK EXPY E
MINOT, ND58701-4768
 Phone: 701-418-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for STACEY D PETERSON · (Female)

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
  • ND License # R32510
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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