Individual
TODD R STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-8600
(262) 329-8601
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(262) 329-8600
(262) 329-8601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
232501
WI
363L00000X
Nurse Practitioner
Primary
10302
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100109584
—
WI
Enumeration date
07/01/2020
Last updated
11/24/2021
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