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General NPI Number Information
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NPI Number | 1275061731
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Entity Type | Individual
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Provider Name | AMANDA JEAN STOKKE APNP
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Gender | Female
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 2301 N LAKE DR HEART FAILURE CLINIC
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City | MILWAUKEE
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State | WI
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Zip | 53211
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Country | US
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Telephone | 414-585-1663
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Fax |
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Provider Business Mailing Address
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Address Line | 2736 N SHOLES AVE
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City | MILWAUKEE
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State | WI
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Zip | 53210-1355
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7581-33
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License Number State | WI
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