Individual
MISS NICOLE I STASIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6941 CHESTER DR APT A, MADISON, WI 53719-1927
(303) 522-8084
Mailing address
6941 CHESTER DR APT A, MADISON, WI 53719-1927
(303) 522-8084
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
171764-30
WI
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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