Provider Demographics
NPI:1811386444
Name:SKORACZEWSKI, STACY ANN (DVM)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ANN
Last Name:SKORACZEWSKI
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 FARM RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-3994
Mailing Address - Country:US
Mailing Address - Phone:715-682-4199
Mailing Address - Fax:715-682-5683
Practice Address - Street 1:2700 FARM RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-3994
Practice Address - Country:US
Practice Address - Phone:715-682-4199
Practice Address - Fax:715-682-5683
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6482-50174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian