Individual
STACEY DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8727 WEST SQUAW LAKE ROAD, LAC DU FLAMBEAU, WI 54538
(715) 604-2538
Mailing address
8727 WEST SQUAW LAKE ROAD, LAC DU FLAMBEAU, WI 54538
(715) 604-2538
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
131620-30
WI
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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