Healthcare Provider Details

I. General information

NPI: 1487602603
Provider Name (Legal Business Name): BARBARA J STANEK QUINN APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 TUTTLE ST
BARABOO WI
53913-3319
US

IV. Provider business mailing address

1700 TUTTLE ST
BARABOO WI
53913-3319
US

V. Phone/Fax

Practice location:
  • Phone: 608-355-3800
  • Fax: 608-355-7001
Mailing address:
  • Phone: 608-355-3800
  • Fax: 608-355-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3908-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number77296-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: