Provider Demographics
NPI:1841519931
Name:STOIK, JANE PEARL (RPH)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:PEARL
Last Name:STOIK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:CORNELL
Mailing Address - State:WI
Mailing Address - Zip Code:54732-0554
Mailing Address - Country:US
Mailing Address - Phone:715-239-6453
Mailing Address - Fax:715-239-6078
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:CORNELL
Practice Address - State:WI
Practice Address - Zip Code:54732-8384
Practice Address - Country:US
Practice Address - Phone:715-239-6453
Practice Address - Fax:715-239-6078
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10170-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist