Nicole R Dassow, NP | |
700 Park Ridge Ln, North Fond Du Lac, WI 54937-1385 | |
(920) 926-7800 | |
(920) 921-3500 |
Full Name | Nicole R Dassow |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 700 Park Ridge Ln, North 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 |
---|---|---|---|
1073237442 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 13161-033 (Wisconsin) | Primary |
363L00000X | Nurse Practitioner | 13161-033 (Wisconsin) | Secondary |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
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Nicole R Dassow, NP 700 Park Ridge Ln, North Fond Du Lac, WI 54937-1385 Ph: (920) 926-7800 | Nicole R Dassow, NP 700 Park Ridge Ln, North Fond Du Lac, WI 54937-1385 Ph: (920) 926-7800 |
Mrs. Amy Sue Gumieny, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 700 Park Ridge Ln, North Fond Du Lac, WI 54937 Phone: 920-926-7800 | |
Denise R Gatien Brux, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 723 Park Ridge Ln, North Fond Du Lac, WI 54937 Phone: 920-926-8600 |