Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 7953 | WI |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 7953-33 | WI |
NPI | 1003334194 |
---|---|
Provider Name | Lauren D Stieber |
First Address | Greenfield, WI 53220-4420 |
Second Address | Greenfield, WI 53220-4420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2017 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100071469 | (05) | WI |