# MEDIVERSE HEALTH & WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750206496
- **Authorized official:** JESSICA STOIBER AGACNP-BC (OWNER)
- **Authorized official phone:** (715) 977-2312

## Contact information

- **Practice address:** 2570 GRACIE DR STE 107, BALDWIN, WI 54002-4403
- **Practice address phone:** (715) 977-2312
- **Practice address fax:** (715) 487-3131
- **Mailing address:** W4401 STATE ROAD 29, SPRING VALLEY, WI 54767-8311
- **Mailing address phone:** (715) 977-2312
- **Mailing address fax:** (715) 487-3131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2026
- **Last updated:** 08/11/2026