Stork, Carol M
Stork, Carol M is an individual health care provider with primary practice located at 2240 Eastridge Center , Eau Claire WI 54701. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Stork, Carol M can be contacted via phone (715) 383-2900.Contact Information
Primary practice address
2240 Eastridge Center
Eau Claire WI 54701
Phone: (715) 383-2900
Fax: (715) 383-2910
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2949-033 | Wisconsin |
Profile Details
NPI number | 1902802978 |
---|---|
LBN Legal business name | Stork, Carol M |
Credentials | RN, FNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 24th, 2005 |
Last updated | Nov 4th, 2010 - about 14 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 | 1902802978 | NPPES |
Oregon | MEDICAID | 239107 |
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