Stacy Lynn Hersrud, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5586 Issued in ND

Practice address

2425 13TH Ave S
Fargo, ND 58103-3749

Phone

(701) 232-4872

NPI assigned

Mar 22, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Drug Stores Delaware LLC

  • Pharmacy
  • Minot, ND
  • NPI 1700828993
  NPD (past)
• American Drug Stores Delaware LLC

  • Pharmacy
  • Fargo, ND
  • NPI 1821039793
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1578094439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033749",
            "telephone_number": "701-232-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033749",
            "telephone_number": "701-232-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSRUD",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "5586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Herrmann
• Thomas Herrmann, CRNA
• Kathryn Alicia Herron, DPM
• Lanessa Hersch, RN
• Jenna Hershberger
• Nicola Ashton Herting, PHD, LP
• Ashley Rae Hertwig-Frieler, PHARMD, RPH
• Steven Nicholas Hertz, MSOT, OTR/L
• Alexis Herzog, OTR/L
• Thomas L Herzog, MD

• All providers in Fargo, ND
• Pharmacist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.