Individual
LISA L BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-7614
(262) 971-9200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3901
WI
363LF0000X
Family Nurse Practitioner
3901-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100009533
—
WI
Enumeration date
12/03/2009
Last updated
01/15/2024
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