Individual
GIDEON JACOB STEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
231 N NATIONAL AVE, FOND DU LAC, WI 54935-2884
(920) 907-8201
(920) 907-8209
Mailing address
1808 W BELTLINE HWY, SSM HEALTH BEHAVIORAL HEALTH, MADISON, WI 53713-2334
(920) 926-8343
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13626-33
WI
Other
Enumeration date
02/21/2023
Last updated
04/10/2023
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