Individual
STEPHANIE M BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
10256 OLD GREEN BAY RD FL 4, KENOSHA, WI 53158-2814
(262) 551-4210
(262) 551-4942
Mailing address
6308 8TH AVE, KENOSHA, WI 53143-5031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8765
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
8765-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891260543
—
WI
01
—
K400519234
MEDICARE
WI
Enumeration date
10/09/2018
Last updated
08/26/2024
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