Individual
STEPHANIE WICKRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
61387
MN
208000000X
Pediatrics Physician
Primary
896
WI
208000000X
Pediatrics Physician
RS2015-0280
NM
Other
Enumeration date
03/30/2015
Last updated
01/29/2021
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