Healthcare Provider Details

I. General information

NPI: 1801722491
Provider Name (Legal Business Name): COGNITIVE CONTINUUM CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 COUNTY ROAD
WINNEBAGO WI
54985-0013
US

IV. Provider business mailing address

PO BOX 13
WINNEBAGO WI
54985-0013
US

V. Phone/Fax

Practice location:
  • Phone: 920-267-7724
  • Fax:
Mailing address:
  • Phone: 920-267-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DONNA J HAWLEY
Title or Position: NURSE PRACTITIONER
Credential: APNP
Phone: 920-210-1259