Individual
MS. LISA R LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
N4405 FRIEDEL AVE, CAMBRIDGE, WI 53523-9719
(608) 692-1141
Mailing address
N4405 FRIEDEL AVE, CAMBRIDGE, WI 53523-9719
(608) 423-9835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39877100
—
WI
Enumeration date
05/06/2006
Last updated
07/09/2007
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