Individual
STACEY L GUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
6 JOHNSON ST, OWEN, WI 54460-9534
(715) 229-2177
(715) 229-4450
Mailing address
6 JOHNSON ST, OWEN, WI 54460-9534
(715) 229-2177
(715) 229-4450
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3467
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851556658
—
WI
01
—
3467
WI LICENSE
WI
Enumeration date
07/22/2008
Last updated
10/01/2009
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