Individual
ELLIE KATHRYN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(262) 323-2081
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(262) 323-2081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7801-23
WI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/01/2022
Last updated
08/08/2025
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