Individual
NICOLE R DASSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
(920) 921-3500
Mailing address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
(920) 921-3500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13161-033
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13161-033
WI
Other
Enumeration date
09/29/2022
Last updated
06/07/2023
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