Boden, Stacy L

Boden, Stacy L is an individual health care provider with primary practice located at 3200 Pleasant Valley Rd , West Bend WI 53095-9274. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Boden, Stacy L can be contacted via phone (262) 334-3451.

Contact Information

Primary practice address
3200 Pleasant Valley Rd West Bend WI 53095-9274
Phone: (262) 334-3451
Fax: (262) 306-2964
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 144166 Wisconsin

Profile Details

NPI number 1124250063
LBN Legal business name Boden, Stacy L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2009
Last updated Aug 11th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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