Individual
BRENDA STALLBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
339 REED AVE, MANITOWOC, WI 54220-2020
(920) 320-8600
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7373-33
WI
Other
Enumeration date
01/19/2017
Last updated
06/21/2019
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