Individual
LISA M BRINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10865 DIAMOND CIR, BLUE MOUNDS, WI 53517-9580
(608) 828-7603
Mailing address
10865 DIAMOND CIR, BLUE MOUNDS, WI 53517-9580
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41315
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245338862
—
WI
Enumeration date
09/20/2006
Last updated
01/22/2022
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