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NPI Code Detail

MEDICARE: STEPHANIE CRASS DO

MEDICARE: STEPHANIE CRASS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207RC0000XCardiovascular Disease Physician82162-21WI

General Provider Information

NPI Number : 1255890430
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE CRASS DO
Provider Business Mailing Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-263-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2019
Last Update Date : 05/12/2026

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