Stacie Barker
Individual provider Active NPI Contractor · Oakdale, MN
NPI 1265970537 · NPPES record last updated Feb 7, 2017
Key facts
- NPI
- 1265970537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 10847801HCBS (MN)
- Practice address
- 3030 Granada Ave N
Suite B
Oakdale, MN 55128-3543 - Phone
- (651) 209-1111
- Fax
- (651) 779-7896
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 10847801HCBS | MN | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 10847801HCBS | MN | Yes |
Addresses
Primary practice location
3030 Granada Ave N
Suite B
Oakdale, MN 55128-3543
Mailing address
3030 Granada Ave N
Suite B
Oakdale, MN 55128-3543
Phone (651) 209-1111
Other providers in Oakdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 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.