Individual
LISA M. BRATVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11040 N STATE RD 77, HAYWARD, WI 54843-3606
(715) 934-4910
(715) 934-4620
Mailing address
11040 N STATE RD 77, HAYWARD, WI 54843-3606
(715) 934-4910
(715) 934-4620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2823
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPR
—
WI
Enumeration date
07/06/2006
Last updated
07/14/2023
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