Individual
LISA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
W129N7055 NORTHFIELD DR, BLDG A, STE 203, MENOMONEE FALLS, WI 53051-0538
(262) 253-7155
(262) 253-7140
Mailing address
W129N7055 NORTHFIELD DR, BLDG A, STE 203, MENOMONEE FALLS, WI 53051-0538
(262) 253-7155
(262) 253-7140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2071
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003986316
—
WI
01
—
1071974
NCCPA
WI
Enumeration date
11/08/2006
Last updated
11/04/2015
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