| Amanda Jo Carlson-dondero, DNP, FNP-BC | |
|
4448 W Loomis Rd, Greenfield, WI 53220-4800 | |
| (414) 281-5150 | |
| Not Available |
| Full Name | Amanda Jo Carlson-dondero |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 4448 W Loomis Rd, Greenfield, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114597168 | NPI | - | NPPES |
| 100182065 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2019053373 (Wisconsin) | Secondary |
| 363L00000X | Nurse Practitioner | 11274-033 (Wisconsin) | Primary |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Jo Carlson-dondero, DNP, FNP-BC Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Amanda Jo Carlson-dondero, DNP, FNP-BC 4448 W Loomis Rd, Greenfield, WI 53220-4800 Ph: (414) 281-5150 |
Lauren D Stieber, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6901 W Edgerton Ave, Greenfield, WI 53220 Phone: 414-325-5244 Fax: 414-421-3772 | |
Susan L Hafemann, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4448 W Loomis Rd, Greenfield, WI 53220 Phone: 414-281-5150 Fax: 414-762-4225 | |
Kinjal Parekh, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8777 W Forest Home Ave, Greenfield, WI 53228 Phone: 414-231-3130 | |
Anna E Seckar-anderson, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6901 W Edgerton Ave, Greenfield, WI 53220 Phone: 414-325-5244 Fax: 414-421-3772 | |
Jane A Kunst, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4131 W Loomis Rd, Suite 300, Greenfield, WI 53221 Phone: 414-325-7246 Fax: 414-325-3770 | |
Ms. Ana M Sanchez, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6901 W Edgerton Ave, Greenfield, WI 53220 Phone: 414-325-5244 Fax: 414-421-3772 | |
Ms. Heidi R Hochhausen, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4131 W Loomis Rd, Suite 300, Greenfield, WI 53221 Phone: 414-325-7246 Fax: 414-325-3770 |