Provider Demographics
NPI:1558246124
Name:HUSIC, INDIRA (DNP FNP APNP)
Entity type:Individual
Prefix:
First Name:INDIRA
Middle Name:
Last Name:HUSIC
Suffix:
Gender:F
Credentials:DNP FNP APNP
Other - Prefix:
Other - First Name:INDRA
Other - Middle Name:
Other - Last Name:BEGIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N5997 MEADOWVIEW LN
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54937-5015
Mailing Address - Country:US
Mailing Address - Phone:920-251-8132
Mailing Address - Fax:
Practice Address - Street 1:420 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-4560
Practice Address - Country:US
Practice Address - Phone:920-926-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17228-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner