Petrie, Stefanie Mae
Petrie, Stefanie Mae is an individual health care provider with primary practice located at 912 S Hickory St , Fond Du Lac WI 54935-5530. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Petrie, Stefanie Mae can be contacted via phone (920) 907-3922.Contact Information
Primary practice address
912 S Hickory St
Fond Du Lac WI 54935-5530
Phone: (920) 907-3922
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Registered Nurse | 163W00000X | 154623030 | Wisconsin |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4135-33 | Wisconsin |
Profile Details
NPI number | 1013247931 |
---|---|
LBN Legal business name | Petrie, Stefanie Mae |
Credentials | APNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 29th, 2009 |
Last updated | Dec 16th, 2020 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013247931 | NPPES |
Wisconsin | MEDICAID | 35033500 |
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