Stanford, Martavia

Stanford, Martavia is an individual health care provider with primary practice located at 120 Bishops Way Ste 165 , Brookfield WI 53005-6249. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Pastoral, Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Home Health Aide, Nursing Service Related Providers / Homemaker, Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician. Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician is her primary health care specialty. Stanford, Martavia can be contacted via phone (414) 355-5525.

Contact Information

Primary practice address
120 Bishops Way Ste 165 Brookfield WI 53005-6249
Phone: (414) 355-5525
Fax: (414) 240-4595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Nursing Service Related Providers / Adult Companion 372600000X
Nursing Service Related Providers / Home Health Aide 374U00000X
Nursing Service Related Providers / Homemaker 376J00000X
Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician 247ZC0005X 52D2261520 Wisconsin

Profile Details

NPI number 1548985930
LBN Legal business name Stanford, Martavia
Credentials LABORATORY DIRECTOR
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2022
Last updated Oct 7th, 2022 - 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 1548985930 NPPES
Wisconsin Other 52D2261520 CLIA STATE OF WISCONSIN

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