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:
Health care specialties
Specialty | Code | License # | 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 16 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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