| Doctor Name: | MRS. STACIE MARIE VALUKAS |
| NPI Number: | 1477995876 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 5356-33 |
| Business Practice Address: | 112 E 5th Ave Antigo, WI - 544092710 |
| Business Phone Number: | 7156232331 |
| Business Fax Number: | |
| Mailing Address: | 517 Virginia St, ANTIGO |
| State: | WI |
| Postal Code: | 544092253 |
| Phone Number: | 7153504354 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2013 |
| NPI Last Update Date: | 07/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 5356-33 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |