Basic Information
Provider Information
NPI: 1427206010
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIERSON
FirstName: DAWN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSN, APNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 725 AMERICAN AVE
Address2: ROOM 2036
City: WAUKESHA
State: WI
PostalCode: 531885031
CountryCode: US
TelephoneNumber: 2629285400
FaxNumber: 2629286140
Practice Location
Address1: 725 AMERICAN AVE
Address2: ROOM 2036
City: WAUKESHA
State: WI
PostalCode: 531885031
CountryCode: US
TelephoneNumber: 2629285400
FaxNumber: 2629286140
Other Information
ProviderEnumerationDate: 09/08/2008
LastUpdateDate: 10/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3492-33WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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