Provider Demographics
NPI:1710684048
Name:GEISSBUHLER, ABBY LEE (DNP, NP-C)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:LEE
Last Name:GEISSBUHLER
Suffix:
Gender:F
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LEE
Other - Last Name:JACOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1801
Mailing Address - Country:US
Mailing Address - Phone:608-877-2777
Mailing Address - Fax:608-877-2774
Practice Address - Street 1:225 CHURCH ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-1801
Practice Address - Country:US
Practice Address - Phone:608-877-2777
Practice Address - Fax:608-877-2774
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13441363L00000X
WI13441-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1710684048Medicaid