MEDICARE: 3D HEALTHCARE CONSULTING LLC

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1720595366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	3D HEALTHCARE CONSULTING LLC

Provider Business Mailing Address
First Line	:	200880 CANOPY LN
Second Line	:
City	:	ROSHOLT
State	:	WI
Zip	:	54473-6705
Country	:	US
Telephone Number	:	715-439-3084
Fax Number	:

Provider Business Practice Location Address
First Line	:	200880 CANOPY LN
Second Line	:
City	:	ROSHOLT
State	:	WI
Zip	:	54473-6705
Country	:	US
Telephone Number	:	715-439-3084
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SALLY A CONWAY
Credential	:
Telephone Number	:	715-439-3084

Provider Enumeration Date	:	01/04/2018
Last Update Date	:	09/28/2025

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