Individual
MRS. LISA L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 738-5369
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5473
WI
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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