Provider Demographics
NPI:1518542703
Name:ANTES, STEPHANIE (APNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ANTES
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:CHOVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3443 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-3703
Mailing Address - Country:US
Mailing Address - Phone:262-496-8091
Mailing Address - Fax:
Practice Address - Street 1:4347 DANBURY LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-4022
Practice Address - Country:US
Practice Address - Phone:262-902-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10011-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily