STEPHANIE WICKSTROM


Address: 1400 Bellinger St., Eau Claire, WI 54702-1510
Phone: 7158386453

STEPHANIE WICKSTROM (NPI# 1255634226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255634226
Entity Type Individual
Full Name STEPHANIE WICKSTROM
Other Name STEPHANIE JENNER
Credential LAT
Practice Address 1400 Bellinger St.
Eau Claire
WI 54702-1510
Mailing Address 1400 Bellinger St.
P.o. Box1510
Eau Claire
WI 54702-1510
Practice Telephone 7158386453
Mailing Telephone 7158386453
Enumeration Date 2010-12-14
Last Update Date 2014-10-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2255A2300X Specialist/Technologist
Specialization: Athletic Trainer
1078-39 WI Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 1400 BELLINGER ST.
City EAU CLAIRE
State WI
Zip Code 54702-1510

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326054727 Mayo Clinic Health System - Pharmacy & Home Medical Inc Durable Medical Equipment & Medical Supplies 1400 Bellinger St., Suite Phm #3, Eau Claire, WI 54703-5222 2006-07-31
1821644923 Mayo Foundation for Medical Education & Research Durable Medical Equipment & Medical Supplies 1400 Bellinger St., Suite Phm #3, Eau Claire, WI 54703-5222 2019-08-14
1295817757 David Randolph Webster Specialist/Technologist 1400 Bellinger St., Eau Claire, WI 54701-1510 2006-10-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801200993 Megan Tumm Physical Therapist 1400 Bellinger St, Eau Claire, WI 54702 2014-06-17
1053385104 Rusty Christopher Brand Orthopaedic Surgery 1400 Bellinger Street, Eau Claire, WI 54702-1510 2006-02-15

Providers in the same city

NPI Name Taxonomy Address Enumeration
1215537501 Seek Chiropractic LLC Chiropractor 405 S Farwell St Ste 21, Eau Claire, WI 54701-2701 2020-10-27
1861099897 Seng Lor Non-emergency Medical Transport (VAN) 2303 Moholt Dr, Eau Claire, WI 54703-2460 2020-10-02
1649887563 Molly Amanda Haferman Pharmacist 3184 London Road, Eau Claire, WI 54701 2020-09-24
1194331298 Adam David Krajnikconde Music Therapist 1241b Menomonie St, Eau Claire, WI 54703-5974 2020-09-23
1548873466 Nurse Staffing and Concierge Service Home Infusion 4418 Echo Valley Dr, Eau Claire, WI 54701-2326 2020-08-29
1225640410 Unity Speech Therapy Speech-Language Pathologist 852 E Prairie Ln Apt 2, Eau Claire, WI 54703-8606 2020-08-19
1518576933 Sonam Bansal Student in an Organized Health Care Education/Training Program 6377 Prairie Cir S, Eau Claire, WI 54701-6792 2020-07-31
1114535929 Eclipse Counseling LLC Clinic/Center 1136 Barron St, Eau Claire, WI 54703 2020-07-17
1285250126 Carol Jean Rudd Massage Therapist 2711 Pleasant St Ste 1e, Eau Claire, WI 54701-2503 2020-06-16
1982229019 Kaitlin Joyce Hollister Student in an Organized Health Care Education/Training Program 5983 N Shore Dr, Eau Claire, WI 54703-2079 2020-06-15
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Taxonomy Information

Taxonomy Code 2255A2300X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Specialist/Technologist
Specialization Athletic Trainer

Taxonomy Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558995126 Ray Johnson Specialist/Technologist 707 Dodge St, Eau Claire, WI 54701-3846 2020-02-23
1801355516 Rebekah Rortvedt Specialist/Technologist 316 9th Ave, Eau Claire, WI 54703-5619 2019-03-13
1932667128 Ryley Freiberg Specialist/Technologist 2743 N Hastings Way, Eau Claire, WI 54703-1272 2019-03-06
1952897399 Daniel Sullivan Specialist/Technologist 2810 Prestige Ct Apt 3, Eau Claire, WI 54703-6424 2018-07-09
1750870630 Peter Minton Specialist/Technologist 1428 Forest Knoll Ct, Eau Claire, WI 54701-5611 2018-05-06
1023519055 Rachel Delanois Specialist/Technologist Kinesiology --mcphee Physical Education Center 208, 509 University Drive, Eau Claire, WI 54701 2018-02-25
1427564863 Matayla Springstroh Specialist/Technologist 509 University Drive, Eau Claire, WI 54701 2017-12-21
1083155063 Mark Byaliy Specialist/Technologist 1108 2nd Ave, Eau Claire, WI 54703-5207 2017-03-10
1447791413 Lucas Hestekin Specialist/Technologist E9805 190th Ave, Eau Claire, WI 54701-1807 2017-03-10
1538600515 Aaron Pelle Specialist/Technologist 457 Summit Ave Apt 1, Eau Claire, WI 54701-4899 2017-03-10
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Competitor

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City EAU CLAIRE
Zip Code 54702

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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