Provider Demographics
NPI:1679642276
Name:STYS, ANN MARIE (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:STYS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 AMERICAN AVE STE 205
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC.
Mailing Address - City:WAUKEHSA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5031
Mailing Address - Country:US
Mailing Address - Phone:262-928-4695
Mailing Address - Fax:262-928-5576
Practice Address - Street 1:721 AMERICAN AVE STE 205
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC.
Practice Address - City:WAUKEHSA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:262-928-4695
Practice Address - Fax:262-928-5576
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704073094363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDEA # MS1174553OtherMID-LEVEL PRACTITIONER
MIDEA # MS1174553OtherMID-LEVEL PRACTITIONER