Smullen, Stephanie R

Smullen, Stephanie R is an individual health care provider with primary practice located at 2845 Greenbrier Rd Ste 240 , Green Bay WI 54311-6519. 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. Smullen, Stephanie R can be contacted via phone (920) 288-8280.

Contact Information

Primary practice address
2845 Greenbrier Rd Ste 240 Green Bay WI 54311-6519
Phone: (920) 288-8280
Fax: (920) 288-8285
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2242 Wisconsin

Profile Details

NPI number 1316117500
LBN Legal business name Smullen, Stephanie R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2008
Last updated Aug 2nd, 2023 - about last year

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 1316117500 NPPES
Michigan MEDICAID 1316117500
Michigan MEDICAID 1316117500

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