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Individual

CAROL M STORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP

Contact information

Practice address
2240 EASTRIDGE CENTER, EAU CLAIRE, WI 54701
(715) 383-2900
(715) 383-2910
Mailing address
2240 EASTRIDGE CTR, EAU CLAIRE, WI 54701-3410
(715) 838-2900
(715) 838-2910

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2949-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
239107
OR
Enumeration date
06/24/2005
Last updated
11/04/2010
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