Healthcare Provider Details

I. General information

NPI: 1588701221
Provider Name (Legal Business Name): NANA NASH CISLER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2733 S RIDGE RD
GREEN BAY WI
54304-5513
US

IV. Provider business mailing address

1009 N 12TH ST
MANITOWOC WI
54220-3208
US

V. Phone/Fax

Practice location:
  • Phone: 920-497-6200
  • Fax: 920-497-3135
Mailing address:
  • Phone: 920-684-4275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1470
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number90-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: