Individual
LISA L CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1004 GARFIELD ST, MADISON, WI 53711-2156
(000) 000-0000
Mailing address
1004 GARFIELD ST, MADISON, WI 53711-2156
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
990
WI
Other
Enumeration date
03/02/2006
Last updated
10/02/2023
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