Individual
MRS. TINA MARIE STEFANIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N. #306931-31
Contact information
Practice address
2935 S. 127TH STREET, NEW BERLIN, WI 53151-4025
(262) 497-6813
Mailing address
4530 CHARLES STREET, RACINE, WI 53402-2760
(262) 497-6813
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306931-31
WI
Other
Enumeration date
03/04/2011
Last updated
03/04/2011
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