Healthcare Provider Details

I. General information

NPI: 1922917954
Provider Name (Legal Business Name): STEPHENIE ANN CERNS-RACH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

4901 N ARDMORE AVE
WHITEFISH BAY WI
53217-6004
US

V. Phone/Fax

Practice location:
  • Phone: 414-284-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number12046-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: