Individual
LORI L WISNEFSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1292 CAPITOL DR, PEWAUKEE, WI 53072-2580
(262) 695-7373
(262) 695-7377
Mailing address
1292 CAPITOL DR, PEWAUKEE, WI 53072-2580
(262) 695-7373
(262) 695-7377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38796
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32339100
—
WI
Enumeration date
08/22/2006
Last updated
09/23/2008
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