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Individual

JOSIE DICESARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
3600 TOWER AVE, SUITE ONE, SUPERIOR, WI 54880-5337
(715) 392-1955
(715) 392-1935
Mailing address
3600 TOWER AVE, SUITE ONE, SUPERIOR, WI 54880-5337
(715) 392-1955
(715) 392-1935

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1729
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-13331
MEDICA
WI
01
015R2WE
BCBS-MN
MN
01
128160-8
LICENSE
MN
01
1729
LICENSE CFNP
WI
01
205368-22
LICENSE CFNP
MN
01
475646313005
BCBS-WI
WI
01
73184
LICENSE
WI
01
87G58WE
BCBS-MN
WI
01
NA9591046225
PREFERREDONE
MN
Enumeration date
08/30/2006
Last updated
12/15/2011
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