Individual
DR. NATALIE A STANKEVYCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4700
(920) 965-4701
Mailing address
923 ELIZA ST, GREEN BAY, WI 54301
(920) 965-4700
(920) 431-7024
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2819-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000207100
MEDICARE PTAN
WI
05
—
38614200
—
WI
Enumeration date
02/20/2007
Last updated
07/21/2022
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