Individual
STACEY VAN SCHYNDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Mailing address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
(920) 337-6741
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313658-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42030700
—
WI
Enumeration date
05/06/2019
Last updated
05/06/2019
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