Individual
NICOLE DUBISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
Mailing address
8897 WINDING TRL, SAINT JOHN, IN 46373-8778
(219) 789-6150
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.012122
IL
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/27/2024
Last updated
04/20/2026
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