NPI 1023360583

Dayna K Niesen, PAC

Practitioner Physician Assistant Green Bay, WI

Practice location

Address: 1726 Shawano Ave, Green Bay, WI 54303-3216
Phone: (414) 290-6720
Fax: (414) 290-6755
Mailing address: 111 E Wisconsin Ave Suite 2000, Milwaukee, WI 53202-4815

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2975-23 (WI)

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Registry record

NPI: 1023360583
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Oct 2012
Record last updated: 19 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.