Provider Demographics
NPI:1609171453
Name:STAT ACCESS
Entity Type:Organization
Organization Name:STAT ACCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PARTNER/ REGISTERED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BYSTREK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-405-9055
Mailing Address - Street 1:PO BOX 370646
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53237-1746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3429 E ALLERTON AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-1017
Practice Address - Country:US
Practice Address - Phone:414-405-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care