Staci Marie Williams, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

12139-040 Issued in WI

Practice address

1028 Horicon St
Mayville, WI 53050-1429

Phone

(920) 387-7800

Fax

(920) 387-7809

NPI assigned

Nov 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Staci Marie Weidler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1205018785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 HORICON ST",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530501429",
            "telephone_number": "920-387-7800",
            "fax_number": "920-387-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 HORICON ST",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530501429",
            "telephone_number": "920-387-7800",
            "fax_number": "920-387-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STACI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12139-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "WEIDLER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PHARM D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith Ann Weber, DPT
• Rachel Werner, COTA
• Pamela Joyce Westdorp, DPT
• Jennifer J Westergaard, APNP
• Erin Williams, PHARMD, RPH
• Brigitte Elise Wittenberger, LPN
• Sandra Ann Zimdars, PHYSICAL THERAPIST

• Pharmacist in Mayville, WI
• Providers in Mayville, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.