Healthcare Provider Details

I. General information

NPI: 1780360834
Provider Name (Legal Business Name): MRS. DONNA SEXSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DONNA LOHSE

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6629 UNIVERSITY AVE STE 209
MIDDLETON WI
53562-3037
US

IV. Provider business mailing address

6304 FORD ST
MONONA WI
53716-3822
US

V. Phone/Fax

Practice location:
  • Phone: 608-833-5880
  • Fax: 608-829-3787
Mailing address:
  • Phone: 920-838-1826
  • Fax: 608-829-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: