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
Fax: (715) 383-2910
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902802978 NPPES
Oregon MEDICAID 239107

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