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Individual
DR. LISA J. HUMFELD-WILSON
Active
Individual
DR. LISA J. HUMFELD-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3817-012
WI
111N00000X
Chiropractor
Primary
4157
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080M0HU
BLUE CROSS BLUE SHIELD
MN
01
—
872833000
MEDICAL ASSISTANCE
MN
Enumeration date
10/04/2005
Last updated
12/22/2011
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