| Stefanie Mae Petrie, APNP | |
|
912 S Hickory St, Fond Du Lac, WI 54935-5530 | |
| (920) 907-3922 | |
| Not Available |
| Full Name | Stefanie Mae Petrie |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 912 S Hickory St, Fond Du Lac, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013247931 | NPI | - | NPPES |
| 35033500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 154623030 (Wisconsin) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 4135-33 (Wisconsin) | Primary |
| Entity Name | Agnesian Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Stefanie Mae Petrie, APNP 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 926-8340 | Stefanie Mae Petrie, APNP 912 S Hickory St, Fond Du Lac, WI 54935-5530 Ph: (920) 907-3922 |
Jeanette Roehl, APNP FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 | |
Mary R Kelm, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8230 | |
Michelle Kehrmeyer, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 209-926-4197 Fax: 920-926-4197 | |
Jessica L Habeck, DNP, APNP, FNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-5020 | |
Mrs. Jennifer Nicole Stephany, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8200 Fax: 920-926-8907 | |
Theresa J Baseley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 Fax: 920-907-7012 | |
Tammy Rae Karls, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8495 |