Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 100620 | WI |
N | 363L00000X | Nurse Practitioner | 341-33 | WI |
NPI | 1013002385 |
---|---|
Provider Name | Lisa Kuester |
First Address | Chippewa Falls, WI 54729-2317 |
Second Address | Rockville, MD 20850-6380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 19/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43831700 | (05) | WI |