Basic Information
| Provider Information | |||||||||
| NPI: | 1003541418 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLACEK | ||||||||
| FirstName: | STEPHANI | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 253 THEILER DR | ||||||||
| Address2: | |||||||||
| City: | TOMAHAWK | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544871733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7156121513 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3233A BUSINESS PARK DR STE 203 | ||||||||
| Address2: | |||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544828861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153444541 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2022 | ||||||||
| LastUpdateDate: | 07/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1089433 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.