Provider Demographics
NPI:1447345368
Name:STOEWE, NANCY GISELA (DC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:GISELA
Last Name:STOEWE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 DURAND AVE
Mailing Address - Street 2:#415
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-4458
Mailing Address - Country:US
Mailing Address - Phone:262-554-5458
Mailing Address - Fax:262-554-7465
Practice Address - Street 1:3701 DURAND AVENUE
Practice Address - Street 2:#415
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405
Practice Address - Country:US
Practice Address - Phone:262-554-5458
Practice Address - Fax:262-554-7465
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T63435Medicare UPIN