STEFANIE MAE PETRIE APNP NPI 1013247931

NPI Information

  • NPI: 1013247931
  • Provider Name: STEFANIE MAE PETRIE, APNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 912 S HICKORY ST
    FOND DU LAC, WI
    ZIP 54935
  • Phone: (920) 907-3922

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NPI Details

Stefanie Mae Petrie, APNP is a family nurse practitioner in Fond Du Lac, WI. Stefanie Mae Petrie, APNP NPI is 1013247931. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

912 S HICKORY ST
FOND DU LAC, WI
ZIP 54935-530
Phone: (920) 907-3922

The NPI 1013247931 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/29/2009 and was last updated on 12/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse154623030WISCONSINNo
2363LF0000XNurse PractitionerFamily4135-33WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
135033500MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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