Provider Demographics
NPI:1285670547
Name:STONE, COURTNEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:STERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3030 HARBOR LN N
Mailing Address - Street 2:STE 227
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5157
Mailing Address - Country:US
Mailing Address - Phone:763-744-1190
Mailing Address - Fax:
Practice Address - Street 1:3030 HARBOR LN N
Practice Address - Street 2:STE 227
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5157
Practice Address - Country:US
Practice Address - Phone:763-744-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7939231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC04978OtherMEDICARE ID NUMBER FOR AUDIOLOGY CONCEPTS