Provider Demographics
NPI:1457632747
Name:STEIN, JENNIFER L (FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:STEIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:HUTJENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8801 MISH KO SWEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CRANDON
Mailing Address - State:WI
Mailing Address - Zip Code:54542
Mailing Address - Country:US
Mailing Address - Phone:715-834-4403
Mailing Address - Fax:
Practice Address - Street 1:8801 MISH KO SWEN DRIVE
Practice Address - Street 2:
Practice Address - City:CRANDON
Practice Address - State:WI
Practice Address - Zip Code:54542
Practice Address - Country:US
Practice Address - Phone:715-843-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4670-33363LF0000X
WI150698163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse