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General NPI Number Information
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NPI Number | 1699918573
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Entity Type | Individual
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Provider Name | STACY KAISER MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 8701 W WATERTOWN PLANK RD
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City | MILWAUKEE
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State | WI
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Zip | 53226-3548
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Country | US
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Telephone | 210-771-7077
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Fax |
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Provider Business Mailing Address
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Address Line | 8701 WATERTOWN PLANK ROAD
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City | MILWAUKEE
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State | WI
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Zip | 53226
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Country | US
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Telephone | 210-771-7077
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 55281-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 55281-20
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License Number State | WI
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