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Individual

DAWN MARGARET NISSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
133215
WI
363L00000X
Nurse Practitioner
Primary
2669
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41270000
WI
Enumeration date
07/24/2006
Last updated
01/15/2021
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