BRENDA STALLBAUM (NPI# 1124565882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124565882 |
| Entity Type | Individual |
| Full Name | BRENDA STALLBAUM |
| Credential | APNP |
| Practice Address |
339 Reed Ave Manitowoc WI 54220-2020 |
| Mailing Address |
Po Box 2290 Manitowoc WI 54221-2290 |
| Practice Telephone | 9203208600 |
| Mailing Telephone | 9203202591 |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
7373-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
339 REED AVE |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437132701 | Lee A Werner | Nurse Practitioner | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2005-11-21 |
| 1457843559 | Callie Schroeder | Psychologist | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2018-06-04 |
| 1932699063 | Amanda Hartwig | Counselor | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2018-05-15 |
| 1457521866 | Mylan Vaugeois Kohler | Psychiatry & Neurology | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2008-03-03 |
| 1447448071 | Robin S Coleman | Clinical Nurse Specialist | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2007-10-09 |
| 1932120607 | Cameron A Goetz | Psychologist | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2006-07-21 |
| 1467473074 | Holy Family Memorial Inc | Clinic/Center | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2006-07-21 |
| 1659391605 | Deborah A Peterman | Counselor | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2006-07-20 |
| 1376563221 | Mary S Christensen | Social Worker | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2006-07-20 |
| 1053331090 | Marianne E Webers | Social Worker | 339 Reed Ave, Manitowoc, WI 54220-2020 | 2006-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
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|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
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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.