Individual
AMY MARIE STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
142 GLENWAY ST, MADISON, WI 53705-5208
(608) 852-4909
Mailing address
142 GLENWAY ST, MADISON, WI 53705-5208
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4393
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
4393
WI
Other
Enumeration date
08/05/2011
Last updated
09/26/2023
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