Provider Demographics
NPI:1285333468
Name:STANEK, ASHLEY NICOLE (RCEP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:STANEK
Suffix:
Gender:F
Credentials:RCEP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:NERENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCE
Mailing Address - Street 1:14585 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WI
Mailing Address - Zip Code:53816-9630
Mailing Address - Country:US
Mailing Address - Phone:608-864-0635
Mailing Address - Fax:
Practice Address - Street 1:205 PARKER ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1642
Practice Address - Country:US
Practice Address - Phone:608-375-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist