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Individual
LISA WILDKNITS BYRNE
Active
Individual
LISA WILDKNITS BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704413688
MI
163WP2201X
Ambulatory Care Registered Nurse
Primary
174068-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155531
LICENSE
WI
01
—
174068-6
LICENSE
MN
Enumeration date
08/23/2006
Last updated
06/12/2025
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