Individual
LISA HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
5000 W CHAMBERS ST, MILWAUKEE, WI 53210-1650
(414) 447-2000
(414) 874-4393
Mailing address
10625 W NORTH AVE, SUITE 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
122075-30
WI
363L00000X
Nurse Practitioner
122075-30
WI
363LF0000X
Family Nurse Practitioner
Primary
3835-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013148980
BLUE CROSS BLUE SHIELD
WI
Enumeration date
07/27/2009
Last updated
05/04/2017
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