Brandon Dillenback, FNP | |
420 E Division St, Fond Du Lac, WI 54935-4560 | |
(920) 926-8573 | |
(920) 926-8923 |
Full Name | Brandon Dillenback |
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Gender | Male |
Speciality | Nurse Practitioner |
Location | 420 E Division St, Fond Du Lac, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275088072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 14338-33 (Wisconsin) | Primary |
Entity Name | Agnesian Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263 |
Mailing Address | Practice Location Address |
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Brandon Dillenback, FNP 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 926-8573 | Brandon Dillenback, FNP 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 926-8573 |
Jeanette Roehl, APNP FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 | |
Mary R Kelm, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8230 | |
Michelle Kehrmeyer, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 209-926-4197 Fax: 920-926-4197 | |
Jessica L Habeck, DNP, APNP, FNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-5020 | |
Mrs. Jennifer Nicole Stephany, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8200 Fax: 920-926-8907 | |
Theresa J Baseley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 Fax: 920-907-7012 | |
Tammy Rae Karls, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8495 |