Individual
MRS. DAWN DEBRA POULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(920) 887-7181
Mailing address
1912 LENORA DR, WEST BEND, WI 53090-2732
(262) 707-4688
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5434-33
WI
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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