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General NPI Number Information
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NPI Number | 1306660956
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Entity Type | Individual
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Provider Name | REBECCA STAPLETON
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 8810 WILLIAM COFFEY DR
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City | WAUWATOSA
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State | WI
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Zip | 53226-1264
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Country | US
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Telephone | 414-805-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 11127 N WESTON DR APT 106
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City | MEQUON
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State | WI
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Zip | 53092-4446
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Country | US
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Telephone | 847-987-3750
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 1101932-30
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License Number State | WI
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