Provider Demographics
NPI:1740243641
Name:STENSLAND, COURTNEY N (PA-C)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:N
Last Name:STENSLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5116
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5116
Mailing Address - Country:US
Mailing Address - Phone:605-331-5890
Mailing Address - Fax:605-336-3974
Practice Address - Street 1:810 E 23RD ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2135
Practice Address - Country:US
Practice Address - Phone:605-331-5890
Practice Address - Fax:605-336-3974
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9835363AS0400X
IA001531363AS0400X
SD0761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0226639Medicaid
MN318632600Medicaid
MN0288350001Medicare NSC
IAI10933Medicare PIN
IA0226639Medicaid
IA0288350006Medicare NSC
IA0288350004Medicare NSC
IA0288350002Medicare NSC
IA0288350001Medicare NSC
MN970007826Medicare ID - Type UnspecifiedWINDOM CLINIC
MN318632600Medicaid
MN0288350002Medicare NSC
MNP00072131Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MN0288350006Medicare NSC
IAQ02647Medicare UPIN
MN970001825Medicare ID - Type UnspecifiedWORTHINGTON CLINIC