Individual
LISA VALIQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 738-4600
(920) 738-4792
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
843
WI
363LF0000X
Family Nurse Practitioner
Primary
843
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43969300
—
WI
Enumeration date
06/18/2006
Last updated
03/17/2018
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