Individual
LISETTE C BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935
(920) 926-8500
(920) 926-8983
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1623023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41993300
—
WI
Enumeration date
07/10/2006
Last updated
04/14/2022
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