Healthcare Provider Details

I. General information

NPI: 1942936257
Provider Name (Legal Business Name): ASHLEY MARIE STEPANOVS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 11/17/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

IV. Provider business mailing address

207 HAWTHORN AVE
MARSHFIELD WI
54449-3218
US

V. Phone/Fax

Practice location:
  • Phone: 715-389-0633
  • Fax:
Mailing address:
  • Phone: 715-383-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11519
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: