Individual
STEPHANIE DAWN BAKA GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APNP, A-GNP-C
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9443-33
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
9443
WI
Other
Enumeration date
09/02/2019
Last updated
10/02/2019
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