MEDICARE: MS. DAWN MARIE FAUST APRN, BC

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	363LA2200X	Adult Health Nurse Practitioner	2007005953	WI

General Provider Information

NPI Number	:	1831384874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN MARIE FAUST APRN, BC

Provider Business Mailing Address
First Line	:	4476 WIND CHIME WAY
Second Line	:
City	:	COTTAGE GROVE
State	:	WI
Zip	:	53527-9729
Country	:	US
Telephone Number	:	920-207-0477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 PARK AVE
Second Line	:
City	:	COLUMBUS
State	:	WI
Zip	:	53925-2401
Country	:	US
Telephone Number	:	920-623-2323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	11/27/2023

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