Chucka, Stephanie Diane

Chucka, Stephanie Diane is an individual health care provider with primary practice located at 252 Mchenry St , Burlington WI 53105-1828. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Chucka, Stephanie Diane can be contacted via phone (262) 767-6000.

Contact Information

Primary practice address
252 Mchenry St Burlington WI 53105-1828
Phone: (262) 767-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3876 - 23 Wisconsin

Profile Details

NPI number 1932654696
LBN Legal business name Chucka, Stephanie Diane
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2016
Last updated Nov 30th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932654696 NPPES
Wisconsin MEDICAID 100061117

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