Provider Demographics
NPI:1528098183
Name:STEFANEC, LYNETTE (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:
Last Name:STEFANEC
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3931 E HAMMOND AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-2010
Mailing Address - Country:US
Mailing Address - Phone:414-482-0926
Mailing Address - Fax:
Practice Address - Street 1:3931 E HAMMOND AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-2010
Practice Address - Country:US
Practice Address - Phone:414-482-0926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38314400Medicare ID - Type UnspecifiedINDEPENDANT NURSE PROVIDE