Provider Demographics
NPI:1457899759
Name:DUSEL, CYNTHIA (APNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DUSEL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2189
Mailing Address - Country:US
Mailing Address - Phone:262-646-9950
Mailing Address - Fax:414-266-6870
Practice Address - Street 1:3195 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2189
Practice Address - Country:US
Practice Address - Phone:262-646-9950
Practice Address - Fax:414-266-6870
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7524-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1457899759Medicaid