Provider Demographics
NPI:1053634964
Name:STELLPFLUG, RENE (RN)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:STELLPFLUG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 DOUGLAS TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3203
Mailing Address - Country:US
Mailing Address - Phone:608-442-0086
Mailing Address - Fax:
Practice Address - Street 1:905 DOUGLAS TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-3203
Practice Address - Country:US
Practice Address - Phone:608-442-0086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI120498-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse