Provider Demographics
NPI:1871630947
Name:NSU INC
Entity Type:Organization
Organization Name:NSU INC
Other - Org Name:CORNERSTONE HEALTHCARE OF ONALASKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TESSIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RENARD
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:608-783-2470
Mailing Address - Street 1:1800 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-7708
Mailing Address - Country:US
Mailing Address - Phone:608-783-2470
Mailing Address - Fax:608-783-2495
Practice Address - Street 1:1800 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-7707
Practice Address - Country:US
Practice Address - Phone:608-783-2470
Practice Address - Fax:608-783-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI500023363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty