STACY L BODEN (NPI# 1124250063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124250063 |
| Entity Type | Individual |
| Full Name | STACY L BODEN |
| Other Name | STACY L VOSKUIL |
| Credential | NP |
| Practice Address |
3200 Pleasant Valley Rd West Bend WI 53095-9274 |
| Mailing Address |
1700 W Paradise Dr West Bend WI 53095-9795 |
| Practice Telephone | 2623343451 |
| Practice Fax Number | 2623062964 |
| Mailing Telephone | 2623343451 |
| Mailing Fax Number | 2623062964 |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
144166 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3200 PLEASANT VALLEY RD |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568453223 | Ajit B Divgi | Internal Medicine | 3200 Pleasant Valley Rd, Kraemer Cancer Care Center, West Bend, WI 53095-9274 | 2005-11-02 |
| 1992328553 | Elizabeth Dille | Family Medicine | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2020-05-18 |
| 1407378086 | Amalia A Brouillard | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2017-07-14 |
| 1194259291 | Amy Mannes | Occupational Therapist | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2017-04-14 |
| 1033667688 | Jennifer Esser | Physician Assistant | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2016-09-12 |
| 1831558113 | Andrea M Pipito | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2016-02-16 |
| 1659743318 | Meghan Lynn Christian | Nurse Practitioner | 3200 Pleasant Valley Rd, Pulmonary Diseases, West Bend, WI 53095-9274 | 2015-10-21 |
| 1043699176 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Clinical Medical Laboratory | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2015-05-21 |
| 1376935395 | Jessica Anne Held | Nurse Practitioner | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2015-02-27 |
| 1053759571 | Froedtert & The Medical College of Wisconsin Community Physicians | Durable Medical Equipment & Medical Supplies | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2013-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750606737 | Sandra Schaefer | Nurse Practitioner | 611 Veterans Ave Ste 106, West Bend, WI 53090-2545 | 2010-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159964 | Caitlin West | Nurse Practitioner | 10823 N Ravine Ct, Mequon, WI 53092-5876 | 2020-06-18 |
| 1639704166 | Angelica Shanahan | Nurse Practitioner | 8733 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-03-04 |
| 1609408210 | Jenna Rae Eisold | Nurse Practitioner | 65 W Wood Ridge Dr, River Falls, WI 54022-8291 | 2020-02-11 |
| 1639685274 | Laura Palmer | Nurse Practitioner | 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 | 2017-12-19 |
| 1306356589 | Alexandra Wilson | Nurse Practitioner | 3033 W Layton Ave # 102, Greenfield, WI 53221-2628 | 2017-10-02 |
| 1689192775 | Brigid Mary Costello | Nurse Practitioner | 9000 W Wisconsin Ave Ste 620, Milwaukee, WI 53226-4874 | 2017-09-08 |
| 1851643696 | Jamie Harder | Nurse Practitioner | 2574 Sun Valley Dr Ste 207, Delafield, WI 53018-2334 | 2012-10-03 |
| 1760731988 | Nancy J Thompson-quandt | Nurse Practitioner | 7831 Warren Ave, Wauwatosa, WI 53213-2115 | 2012-09-04 |
| 1932471018 | Marie Helen Dietrich | Nurse Practitioner | 201 S Gammon Rd, Madison, WI 53717-1404 | 2012-02-03 |
| 1598993925 | Rebecca R. Rusch | Nurse Practitioner | 13950 W. W. Capitol Drive, Suite 200, Brookfield, WI 53005-2441 | 2009-06-24 |
| Find all providers with the same taxonomy | ||||
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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.