Individual
AMY H STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-0070
(920) 831-7939
Mailing address
10 TRI PARK WAY, APPLETON, WI 54914-1658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Enumeration date
07/20/2006
Last updated
07/21/2022
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