Individual
STACY LEIGH LICHTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
N95W25901 COUNTY LINE RD STE F, COLGATE, WI 53017-9225
(262) 628-3727
Mailing address
W197N12556 PRAIRIE RIDGE CT, RICHFIELD, WI 53076-9443
(414) 526-1338
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
15927-33
WI
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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