NPI 1487491932

Stacy Jo Upton

Practitioner Home Modifications Contractor Isanti, MN

Practice location

Address: 28115 Lily St NW, Isanti, MN 55040-5995
Phone: (763) 238-9261

Registered specialties

Home Modifications Contractor Primary

Other Service Providers Taxonomy 171WH0202X Licence AS779871 (MN)

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Registry record

NPI: 1487491932
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jul 2024
Record last updated: 11 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.