Provider Demographics
NPI:1063050235
Name:STIEBINGER, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:STIEBINGER
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 1:23671 SAINT FRANCIS BLVD NW STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:MN
Mailing Address - Zip Code:55070-9803
Mailing Address - Country:US
Mailing Address - Phone:763-213-0615
Mailing Address - Fax:763-213-0616
Practice Address - Street 1:23671 SAINT FRANCIS BLVD NW STE 102
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070-9803
Practice Address - Country:US
Practice Address - Phone:763-213-0615
Practice Address - Fax:763-213-0616
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist