Stacie Berberich
Individual provider Active NPI Licensed Practical Nurse · Mandan, ND
NPI 1053858258 · NPPES record last updated Jan 25, 2017
Key facts
- NPI
- 1053858258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- L15155 (ND)
- Practice address
- 1200 Collins Ave
Mandan, ND 58554-2066 - Phone
- (701) 663-5373
- NPI assigned
- Jan 25, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L15155 | ND | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dakota Home Care, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L15155 | ND | Yes |
Addresses
Primary practice location
1200 Collins Ave
Mandan, ND 58554-2066
Mailing address
1200 Collins Ave
Mandan, ND 58554-2066
Phone (701) 663-5373
Other providers in Mandan, ND
- Lance J. Belohlavek
- Gretchen G Belzer-Curl
- Garrett Frank Bennett
- Steven H Bennett
- Danielle Jaylyn Benz
- Trina Bercier
- Patty Lurz Berger
- Stacey Ann Berthiaume
- Tricia Bibeault
- Michelle Bier
All providers in Mandan, ND · Licensed Practical Nurse in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.