Bantell, Stephanie L
Bantell, Stephanie L is an individual health care provider with primary practice located at 610 W Adams St , Black River Falls WI 54615. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bantell, Stephanie L can be contacted via phone (715) 284-4311.Contact Information
Primary practice address
610 W Adams St
Black River Falls WI 54615
Phone: (715) 284-4311
Fax: (715) 284-0475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 57440-20 | Wisconsin |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 3928-850 | Wisconsin |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 57440-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 41109 | Iowa |
Profile Details
| NPI number | 1225314131 |
|---|---|
| LBN Legal business name | Bantell, Stephanie L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2011 |
| Last updated | Sep 21st, 2018 - about 6 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 | 1225314131 | NPPES |
| Wisconsin | Other | 57440-20 | WI STATE LICENSE |
| Wisconsin | Other | 41109 | WI STATE LICENSE |
| Wisconsin | Other | 3928-850 | WI STATE LICENSE |
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