White, Staci
White, Staci is an individual health care provider with primary practice located at 4502 Milwaukee St , Madison WI 53714-2133. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. White, Staci can be contacted via phone (608) 249-2137.Contact Information
Primary practice address
4502 Milwaukee St
Madison WI 53714-2133
Phone: (608) 249-2137
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant | 224Z00000X | 947027 | Wisconsin |
Profile Details
| NPI number | 1366560377 |
|---|---|
| LBN Legal business name | White, Staci |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1366560377 | NPPES |
| Wisconsin | MEDICAID | 40740300 |
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