Individual
STACEY M. FASHINGBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, LAT
Contact information
Practice address
444 E TIMBER DR, RHINELANDER, WI 54501-2852
(715) 369-2300
Mailing address
444 E TIMBER DR, RHINELANDER, WI 54501-2852
(715) 369-2300
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1151
WI
363A00000X
Physician Assistant
Primary
5471-23
WI
Other
Enumeration date
12/17/2012
Last updated
10/01/2021
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