Healthcare Provider Details

I. General information

NPI: 1841828613
Provider Name (Legal Business Name): CARRIE HESSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S NICOLET RD
APPLETON WI
54914-8273
US

IV. Provider business mailing address

100 N EAST AVE
WAUKESHA WI
53186-3103
US

V. Phone/Fax

Practice location:
  • Phone: 920-886-2299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: