DR. STACEY RAE LEJEUNE (NPI# 1114261591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114261591 |
| Entity Type | Individual |
| Full Name | DR. STACEY RAE LEJEUNE |
| Credential | M.D. |
| Practice Address |
2400 Pine Ridge Blvd Wausau WI 54401-7803 |
| Practice Telephone | 7158472022 |
| Mailing Telephone | 7158472022 |
| Enumeration Date | 2012-11-25 |
| Last Update Date | 2019-06-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
70750 | WI | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
61552 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 516 Delaware St Se, Minneapolis, MN 554550356 | 6126251485 |
| Street Address |
2400 PINE RIDGE BLVD |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-7803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558363432 | James P. Binder | Surgery | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2005-08-11 |
| 1760080584 | Sabrina Pfannsmith | Specialist/Technologist, Other | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2020-10-14 |
| 1952961633 | Ellen A Humberston | Physician Assistant | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2019-06-16 |
| 1154816437 | Anthony Vincent Hull | Physician Assistant | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2018-06-28 |
| 1144733742 | Sarah Adams | Specialist/Technologist, Other | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2017-11-06 |
| 1982129888 | Suzanne Solin | Physician Assistant | 2400 Pine Ridge Blvd, Wausau, WI 54401 | 2017-08-11 |
| 1528514338 | Joan Spindler | Specialist/Technologist, Other | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2016-08-31 |
| 1083160865 | Linda Blume | Specialist/Technologist, Other | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2016-08-31 |
| 1902271190 | Kerry Coenen | Specialist/Technologist, Other | 2400 Pine Ridge Blvd, Wausau, WI 54401-7803 | 2015-12-14 |
| 1447593835 | Jeremiah Olson | Surgery | 2400 Pine Ridge Blvd, Wausau, WI 54401 | 2013-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649454489 | Warren H De Kraay Sr. | Surgery | 3325 Pleasant Lane, Racine, WI 53405 | 2007-12-27 |
| 1932308186 | Great Lakes Medical & Surgical Center | Surgery | 6000 South 27th Street, Milwaukee, WI 53221 | 2007-07-17 |
| 1215020326 | Richard J Grieshop | Surgery | 2424 S 90th St Ste 300, West Allis, WI 53227-2455 | 2006-10-02 |
| 1740245356 | Deborah L Manjoney | Surgery | 1231 George Towne Drive, Suite G, Pewaukee, WI 53072 | 2006-04-18 |
| 1104880814 | William D Turnipseed | Surgery | 2128 Bridge Ln, Verona, WI 53593-8838 | 2006-04-12 |
| 1104803352 | John W Oren | Surgery | 10509 N Manor Cir, Mequon, WI 53092-5172 | 2005-12-29 |
| 1649264441 | Milan Jordan | Surgery | 2300 Western Ave, Manitowoc, WI 54220-3712 | 2005-09-07 |
| 1275157943 | Neurospine and Endovascular Center LLC | Surgery | 10500 W Loomis Rd Ste 120, Franklin, WI 53132-8030 | 2020-05-29 |
| 1699200378 | Andrea Um | Surgery | Uw Hospitals and Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2017-05-01 |
| 1861855017 | Alexander Donald Leung | Surgery | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2016-04-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.