Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 21883 | WI |
NPI | 1003884974 |
---|---|
Provider Name | Patricia V Staats |
First Address | Madison, WI 53711-3505 |
Second Address | Madison, WI 53711-3505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 20/04/2020 |