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STEFANIE MAE PETRIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
912 S HICKORY ST, FOND DU LAC, WI 54935-5530
(920) 907-3922
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
154623030
WI
363LF0000X
Family Nurse Practitioner
Primary
4135-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35033500
WI
Enumeration date
12/29/2009
Last updated
12/16/2020
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