Healthcare Provider Details

I. General information

NPI: 1639427040
Provider Name (Legal Business Name): PATRICIA ANN STEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 S LAYTON BLVD
MILWAUKEE WI
53215-1924
US

IV. Provider business mailing address

1555 S LAYTON BLVD
MILWAUKEE WI
53215-1924
US

V. Phone/Fax

Practice location:
  • Phone: 414-385-6600
  • Fax: 414-944-0017
Mailing address:
  • Phone: 414-385-6600
  • Fax: 414-944-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number87893-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: