Individual
LISA NEYENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-2219
Mailing address
6308 8TH AVE, KENOSHA, WI 53143-5031
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
17339
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17339
PHARMACIST LICENSE
WI
Enumeration date
05/02/2020
Last updated
11/27/2023
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