Individual
STACEE PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6355 S 35TH ST, APT 91, FRANKLIN, WI 53132-9405
(406) 212-4461
Mailing address
6355 S 35TH ST, APT 91, FRANKLIN, WI 53132-9405
(406) 212-4461
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318832
WI
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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