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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013247931 NPPES
Wisconsin MEDICAID 35033500

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