Healthcare Provider Details

I. General information

NPI: 1205448222
Provider Name (Legal Business Name): DAKOTA ANN DROLSHAGEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1567 FALCON DR
HARTFORD WI
53027-2780
US

IV. Provider business mailing address

1567 FALCON DR
HARTFORD WI
53027-2780
US

V. Phone/Fax

Practice location:
  • Phone: 920-392-6656
  • Fax:
Mailing address:
  • Phone: 920-392-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number242397
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: