Individual
LISA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 805-2764
Mailing address
210 S WATER ST UNIT 520, MILWAUKEE, WI 53204-4314
(414) 630-0578
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
5069
WI
Other
Enumeration date
04/12/2012
Last updated
08/01/2024
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