Provider Demographics
NPI:1386645141
Name:STANFIELD, LOUIS GREENE II (CRNA, PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:GREENE
Last Name:STANFIELD
Suffix:II
Gender:M
Credentials:CRNA, PHD
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Mailing Address - Street 1:63 FERRIS LANE
Mailing Address - Street 2:UNIT K6
Mailing Address - City:BARRIE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L4M5C4
Mailing Address - Country:CA
Mailing Address - Phone:651-270-6849
Mailing Address - Fax:800-631-6136
Practice Address - Street 1:1730 GRAHAM AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3090
Practice Address - Country:US
Practice Address - Phone:651-270-6849
Practice Address - Fax:800-631-6136
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2009-11-09
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Provider Licenses
StateLicense IDTaxonomies
MNR1386176367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCB8050KMedicaid
AL39723Medicaid
MN430003046Medicaid
ILR20876Medicaid
INCB8050KMedicaid