Provider Demographics
NPI:1609985589
Name:DICESARE, JOSIE (CFNP)
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:DICESARE
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:3600 TOWER AVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-5337
Mailing Address - Country:US
Mailing Address - Phone:715-392-1955
Mailing Address - Fax:715-392-1935
Practice Address - Street 1:3600 TOWER AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5337
Practice Address - Country:US
Practice Address - Phone:715-392-1955
Practice Address - Fax:715-392-1935
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1729OtherLICENSE CFNP
WI73184OtherLICENSE
MN205368-22OtherLICENSE CFNP
MNNA9591046225OtherPREFERREDONE
WI01-13331OtherMEDICA
MN128160-8OtherLICENSE
WI475646313005OtherBCBS-WI
WI87G58WEOtherBCBS-MN
MN015R2WEOtherBCBS-MN