Provider Demographics
NPI:1124312863
Name:ELSE, STEPHANIE J (AUD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:J
Last Name:ELSE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:JOY
Other - Last Name:ELSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1705 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6151
Practice Address - Country:US
Practice Address - Phone:218-333-5000
Practice Address - Fax:218-333-5880
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-28
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3762231H00000X
237600000X, 332S00000X
MN10622231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No332S00000XSuppliersHearing Aid Equipment