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Organization
MEDIVERSE HEALTH & WELLNESS LLC
Active
Organization
MEDIVERSE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA STOIBER AGACNP-BC (OWNER)
(715) 977-2312
Entity
Organization
Contact information
Practice address
2570 GRACIE DR STE 107, BALDWIN, WI 54002-4403
(715) 977-2312
(715) 487-3131
Mailing address
W4401 STATE ROAD 29, SPRING VALLEY, WI 54767-8311
(715) 977-2312
(715) 487-3131
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/11/2026
Last updated
08/11/2026
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