Individual
ASHLEY RAE WENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5412 US HIGHWAY 10 E, STEVENS POINT, WI 54482
(714) 346-5243
Mailing address
1064 RUSSELL ST, KRONENWETTER, WI 54455-9052
(715) 340-8635
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4401
WI
363AM0700X
Medical Physician Assistant
4401-23
WI
Other
Enumeration date
06/18/2018
Last updated
07/12/2018
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