Mary Stephanie Wright, APNP
Individual provider Active NPI Primary Care Nurse Practitioner · Kiel, WI
NPI 1790057560 · NPPES record last updated Sep 22, 2025
Key facts
- NPI
- 1790057560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 4767-33 (WI)
- Practice address
- 502 Highway 67
Kiel, WI 53042-1650 - Phone
- (920) 894-5661
- Fax
- (920) 894-1120
- NPI assigned
- Feb 8, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120502000686 | WI | Practitioner - Nurse Practitioner | 7911169206 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prevea Clinic, Inc. | Current |
Accepting new patients | |
| St. Nicholas Hospital-Sisters of the Third Order of St Francis | Current |
Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current |
Accepting new patients | |
| Prevea Clinic, Inc. | Current |
Accepting new patients |
Locations
1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016
2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
502 Highway 67
Kiel, WI 53042
Phone (920) 894-5661
825 Walton Dr
Plymouth, WI 53073
Phone (920) 451-7304
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
1020 S Taylor Dr
Sheboygan, WI 53081
Phone (920) 452-5437
Interoperability endpoints
- mschad39078@ewd.direct.hshs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 4767-33 | WI | Yes |
| Nurse Practitioner | 363L00000X | 4767 | WI |
Addresses
Primary practice location
502 Highway 67
Kiel, WI 53042-1650
Mailing address
334 Emerald Hills Dr
Fredonia, WI 53021-9351
Phone (262) 483-4374
Other practice location 1
334 Emerald Hills Dr
Fredonia, WI 53021-9351
Phone (262) 483-4374
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01063882 | Other | WI | RR MEDICARE |
Other providers in Kiel, WI
All providers in Kiel, WI · Primary Care Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.