Healthcare Provider Details

I. General information

NPI: 1376464016
Provider Name (Legal Business Name): CHERI LETRECE STUTTLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

5165 N BERKELEY BLVD APT 1
MILWAUKEE WI
53217-5505
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax: 414-382-5102
Mailing address:
  • Phone: 414-384-2000
  • Fax: 414-382-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number132839-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: