Provider Demographics
NPI:1023709011
Name:GOODREAU, DAWN MICHELLE (NNP-BC, APNP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:GOODREAU
Suffix:
Gender:F
Credentials:NNP-BC, APNP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MICHELLE
Other - Last Name:DEPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W279N8778 TWIN PINES CIR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8593
Mailing Address - Country:US
Mailing Address - Phone:210-685-0887
Mailing Address - Fax:
Practice Address - Street 1:725 AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:210-685-0887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13883-33363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal