Provider Demographics
NPI:1558134551
Name:WINDESHAUSEN, CONTESSA MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CONTESSA
Middle Name:MARIE
Last Name:WINDESHAUSEN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S LOUISE AVE UNIT 90332
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57109-4669
Mailing Address - Country:US
Mailing Address - Phone:605-250-1200
Mailing Address - Fax:
Practice Address - Street 1:2501 S LOUISE AVE UNIT 90332
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57109-4669
Practice Address - Country:US
Practice Address - Phone:605-250-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG176261363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health