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Individual

NANCY L LASSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
(149) 554-6282
Mailing address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
(149) 554-6282

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
115274-030
WI
363L00000X
Nurse Practitioner
Primary
5507-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487808598
WI
Enumeration date
11/17/2008
Last updated
10/31/2024
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