Individual ProviderStephanie RubachNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669(414) 384-5111(800) 326-2250PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Rubach is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1023630258Provider TypeIndividualFull NameRubach, StephanieCredentialAPNPGenderFemaleSole ProprietorNoEnumeration Date5/11/2020Last Updated1/28/2026Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669Phone(414) 384-5111FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 326-2250FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense9903-33WisconsinCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense9903-33WisconsinProvider IdentifiersIDDescriptionIssuerID100099442DescriptionMedicaidIssuerUnlistedWisconsin