Provider Demographics
NPI:1720341654
Name:SCHRANDT, STACY K (RN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:K
Last Name:SCHRANDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29744 ONYX RD
Mailing Address - Street 2:
Mailing Address - City:CASHTON
Mailing Address - State:WI
Mailing Address - Zip Code:54619-5200
Mailing Address - Country:US
Mailing Address - Phone:608-381-0872
Mailing Address - Fax:
Practice Address - Street 1:29744 ONYX RD
Practice Address - Street 2:
Practice Address - City:CASHTON
Practice Address - State:WI
Practice Address - Zip Code:54619-5200
Practice Address - Country:US
Practice Address - Phone:608-381-0872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI315857-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse