Provider Demographics
NPI:1861842569
Name:BURANDT, STEFANI ERIN
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:ERIN
Last Name:BURANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFANI
Other - Middle Name:ERIN
Other - Last Name:EGNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 CONNECTICUT AVE S
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377
Mailing Address - Country:US
Mailing Address - Phone:320-259-4100
Mailing Address - Fax:
Practice Address - Street 1:1901 CONNECTICUT AVE S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377
Practice Address - Country:US
Practice Address - Phone:320-259-4100
Practice Address - Fax:320-257-5523
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant