Broderick Stefanik

Individual provider Active NPI Basic Emergency Medical Technician · Birchwood, WI

NPI 1487570404 · NPPES record last updated Jun 24, 2026

Key facts

NPI
1487570404
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
70124316 (WI)
Practice address
N1910 Scout Rd
Birchwood, WI 54817-8906
Phone
(612) 261-2455
NPI assigned
Jun 24, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 70124316 WI Yes

Addresses

Primary practice location

N1910 Scout Rd
Birchwood, WI 54817-8906

Mailing address

N1910 Scout Rd
Birchwood, WI 54817-8906

Other providers in Birchwood, WI

All providers in Birchwood, WI · Basic Emergency Medical Technician in Wisconsin

Sources for this page

Verify at the official NPI Registry.