Provider Demographics
NPI:1376391938
Name:CORTES, STEPHANIE D (CNA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:CORTES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 MONTREAL ST APT 112
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0369
Mailing Address - Country:US
Mailing Address - Phone:701-400-5225
Mailing Address - Fax:
Practice Address - Street 1:4105 MONTREAL ST APT 112
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0369
Practice Address - Country:US
Practice Address - Phone:701-400-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND40859376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide