Provider Demographics
NPI:1598229585
Name:STEBLAY, NATALIE JEAN
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JEAN
Last Name:STEBLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2210
Mailing Address - Country:US
Mailing Address - Phone:952-500-2275
Mailing Address - Fax:
Practice Address - Street 1:1638 9TH ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2210
Practice Address - Country:US
Practice Address - Phone:952-500-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program