Provider Demographics
NPI:1821272998
Name:WALDRON-TRAPP, STEPHANI LOUISE (ND)
Entity Type:Individual
Prefix:
First Name:STEPHANI
Middle Name:LOUISE
Last Name:WALDRON-TRAPP
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 112TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3207
Mailing Address - Country:US
Mailing Address - Phone:612-250-2804
Mailing Address - Fax:
Practice Address - Street 1:232 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1245
Practice Address - Country:US
Practice Address - Phone:612-250-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath