Provider Demographics
NPI:1912914581
Name:STRAND, MARY ELLEN (APNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:STRAND
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELLEN
Other - Last Name:BURGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:3354 MIDWAY ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-1167
Mailing Address - Country:US
Mailing Address - Phone:715-271-1000
Mailing Address - Fax:715-720-4763
Practice Address - Street 1:2240 EASTRIDGE CTR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3410
Practice Address - Country:US
Practice Address - Phone:715-838-2900
Practice Address - Fax:715-838-2910
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2673-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health