Provider Demographics
NPI:1467904946
Name:KRAL, STEPHANIE JOANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:JOANNE
Last Name:KRAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5969
Mailing Address - Country:US
Mailing Address - Phone:715-389-3618
Mailing Address - Fax:715-221-6657
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5444
Practice Address - Country:US
Practice Address - Phone:608-475-0615
Practice Address - Fax:715-221-6657
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06688363AM0700X, 363A00000X
IL085009004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical