Healthcare Provider Details

I. General information

NPI: 1407016025
Provider Name (Legal Business Name): REBECCA STASKA JANKOWSKI L.AC, MSOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3174 S HOWELL AVE
MILWAUKEE WI
53207-2625
US

IV. Provider business mailing address

3174 S HOWELL AVE
MILWAUKEE WI
53207-2625
US

V. Phone/Fax

Practice location:
  • Phone: 414-435-2772
  • Fax:
Mailing address:
  • Phone: 414-435-2772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number486-055
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: