Individual
MS. NICOLETTE ELLA WEISENSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
129 HOSPITAL DR, WATERTOWN, WI 53098-3334
(920) 262-4800
(920) 262-4813
Mailing address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5000
(920) 568-4004
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
43679-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34591800
—
WI
Enumeration date
08/31/2005
Last updated
02/06/2015
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