Provider Demographics
NPI:1750348470
Name:BUSSE-QUENAN, DANIELLE R (DO)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:R
Last Name:BUSSE-QUENAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:265 GRIFFIN ST E
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1439
Mailing Address - Country:US
Mailing Address - Phone:715-268-8000
Mailing Address - Fax:715-268-0311
Practice Address - Street 1:265 GRIFFIN ST E
Practice Address - Street 2:ARMC
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1439
Practice Address - Country:US
Practice Address - Phone:715-268-8000
Practice Address - Fax:715-268-0311
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37864021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G36301OtherAMERICA'S PPO
390908320OtherSTANDARD TAX ID NUMB
HP60877OtherHEALTH PARTNERS
32289900OtherGROUP HEALTH OF EAU
P00341824OtherPALMETTO GBA RR ME
312P88UOtherBLUE CROSS BLUE SHIE
WI32289900Medicaid
0124794OtherMEDICA PROVIDER NUMB
102691OtherSECURITY HEALTH PLAN
1016661OtherPREFERRED ONE
102691OtherSECURITY HEALTH PLAN
HP60877OtherHEALTH PARTNERS
G36301OtherAMERICA'S PPO