Provider Demographics
NPI:1134278286
Name:MESSNER, STACY LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:MESSNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LYNN
Other - Last Name:GEHRKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1095 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5000
Mailing Address - Country:US
Mailing Address - Phone:230-234-5000
Mailing Address - Fax:
Practice Address - Street 1:1095 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5000
Practice Address - Country:US
Practice Address - Phone:230-234-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101107225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist