person
Mrs. Heather L Stack, PA-C
Surgical Physician Assistant in West Bend, Wisconsin
NPI 1841244993

Heather L Stack is a Surgical Physician Assistant based in West Bend, WI and is specialized in Surgical. Heather L Stack practices in West Bend, WI and has the professional credentials of PA-C. The NPI Number for Heather L Stack is 1841244993 and holds a License No. 1541 (Wisconsin).

The current practice location address for Heather L Stack is 3200 Pleasant Valley Rd, West Bend, WI and can be reached out via phone at 262-836-7344 and via fax at 262-836-7372. You can also correspond with Heather L Stack through the mailing address at 3200 PLEASANT VALLEY RD, WEST BEND, WI - 53095-9274 (mailing address contact number: 262-836-7344).

Location: 3200 Pleasant Valley Rd, West Bend, WI, 53095-9274
person
Provider Profile Details
NPI Number
1841244993
Provider Name
Heather L Stack
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
3200 Pleasant Valley Rd, West Bend, WI, 53095-9274
Phone Number
262-836-7344
Fax Number
262-836-7372
Provider Enumeration Date
05/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
008000261J 01 HUMANA
1841244993 05 WI
institution
Provider Business Practice Location Address Details
Address
3200 Pleasant Valley Rd
City
State
Zip
53095-9274
Phone Number
262-836-7344
Fax Number
262-836-7372
person
Provider Business Mailing Address Details
Address
3200 Pleasant Valley Rd
City
State
Zip
53095-9274
Phone Number
262-836-7344
Fax Number
262-836-7372
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
1541 (Wisconsin)
Definition
Definition to come...
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