Individual
ANGELA MAE STOMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
105 GARFIELD AVE, EAU CLAIRE, WI 54701-4811
(715) 836-5010
Mailing address
3615 GREENDALE CT, EAU CLAIRE, WI 54701-9217
(715) 832-5520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20040001-22
MN
363LF0000X
Family Nurse Practitioner
Primary
3394
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36061300
—
WI
Enumeration date
03/23/2007
Last updated
03/11/2013
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