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Individual

MS. LISA LAUREN ANTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN/BC/APNP

Contact information

Practice address
3915 N RIDGEFIELD CIR, SHOREWOOD, WI 53211-2451
(414) 467-4162
(414) 906-1758
Mailing address
3915 N RIDGEFIELD CIR, SHOREWOOD, WI 53211-2451
(414) 467-4162
(414) 906-1758

Taxonomy

Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
2531-033
WI
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
WI

Other

Enumeration date
08/13/2007
Last updated
08/13/2007
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