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1124565882
BRENDA STALLBAUM
MANITOWOC, WI
NPI
1124565882
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WI 7373-33)
Enumeration Date
2017-01-19
Last Update Date
2019-06-21
Business Address
BRENDA STALLBAUM APNP
339 REED AVE
MANITOWOC, WI 54220-2020
Phone number: 920-320-8600
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Mailing Address
BRENDA STALLBAUM APNP
PO BOX 2290
MANITOWOC, WI 54221-2290
Phone number: 920-320-2591
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