Individual
DR. LISA MARIE HENRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 W NATIONAL AVE, DEPT OF PSYCHIATRY, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5379
Mailing address
5000 W NATIONAL AVE, DEPT OF PSYCHIATRY, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45710-20
WI
2084P0800X
Psychiatry Physician
Primary
45710-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34439000
—
WI
Enumeration date
10/02/2006
Last updated
02/26/2014
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