Healthcare Provider Details

I. General information

NPI: 1861672040
Provider Name (Legal Business Name): COUNTY OF DUNN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 US HIGHWAY 12 E
MENOMONIE WI
54751-5569
US

IV. Provider business mailing address

3001 US HIGHWAY 12 E
MENOMONIE WI
54751-5569
US

V. Phone/Fax

Practice location:
  • Phone: 715-232-2661
  • Fax: 715-232-4010
Mailing address:
  • Phone: 715-232-2661
  • Fax: 715-232-4010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CARMEN MEYER
Title or Position: ADMINISTRATOR
Credential:
Phone: 715-232-2661