Healthcare Provider Details

I. General information

NPI: 1437519097
Provider Name (Legal Business Name): DAWN WIND MUELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 DEWITT ST
PORTAGE WI
53901-2114
US

IV. Provider business mailing address

25 KESSEL CT STE 105
MADISON WI
53711-6227
US

V. Phone/Fax

Practice location:
  • Phone: 608-745-9292
  • Fax:
Mailing address:
  • Phone: 608-280-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: