Individual provider · Type 1 NPI

Stacy L. Boden, NP

Pediatric Nurse Practitioner · West Bend, WI

NPI number 1124250063 Active

Practice location

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Fax (262) 306-2964

Mailing address

1700 W Paradise Dr
West Bend, WI 53095-9795

Other practice locations

  • 8057 Spyglass Hill Rd Ste 102, Viera, FL 32940-8565 · (321) 435-9800

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X144166 (WI)
Pediatric Nurse Practitioner 363LP0200XAPRN11047916 (FL)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1124250063

Stacy L. Boden, NP's National Provider Identifier is 1124250063, issued on Aug 11, 2009. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in West Bend, WI. The record was last updated on Jun 15, 2026.