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NPI Code Detail

MEDICARE: DYLAN G WASHKUHN NP

MEDICARE:   DYLAN G WASHKUHN  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner253785WI
2363L00000XNurse Practitioner14053WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174217467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN G WASHKUHN NP
Provider Business Mailing Address
First Line : 417 GANNON CT
Second Line :
City : TOMAH
State : WI
Zip : 54660-6586
Country : US
Telephone Number : 210-860-8343
Fax Number :
Provider Business Practice Location Address
First Line : 6901 W EDGERTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4420
Country : US
Telephone Number : 414-325-5244
Fax Number : 414-421-3772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2023
Last Update Date : 04/06/2026

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