Individual
STEPHANIE KOURTJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1240 UNIVERSITY BAY DR, MADISON, WI 53705-2253
(616) 970-8072
Mailing address
1240 UNIVERSITY BAY DR, MADISON, WI 53705-2253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0008716
CO
363AS0400X
Surgical Physician Assistant
Primary
5374
WI
Other
Enumeration date
04/23/2020
Last updated
12/26/2024
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