Provider Demographics
NPI:1548064181
Name:NORD, STEPHANIE JEAN
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JEAN
Last Name:NORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 WAKEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1131
Mailing Address - Country:US
Mailing Address - Phone:701-331-2947
Mailing Address - Fax:
Practice Address - Street 1:159 WAKEMAN AVE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1131
Practice Address - Country:US
Practice Address - Phone:701-331-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant