Individual
DR. RENEE A STAEHLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
515 E MILL ST., PLYMOUTH, WI 53073-1807
(920) 892-4311
(920) 893-5978
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(920) 892-4311
(920) 893-5978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34889
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31997100
—
WI
Enumeration date
04/21/2006
Last updated
06/12/2012
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