Individual
MS. LISA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1675 HIGHLAND AVE, ROOM P4 4118, MADISON, WI 53792-0002
(608) 890-8198
(608) 265-9721
Mailing address
1675 HIGHLAND AVE, ROOM P4 4118, MADISON, WI 53792-0002
(608) 890-8198
(608) 265-9721
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
104212-030
WI
363LP0200X
Pediatric Nurse Practitioner
Primary
97062
WI
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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