Individual
LISA M GROTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 225-1414
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
186139
WI
363LF0000X
Family Nurse Practitioner
Primary
9650
WI
Other
Enumeration date
06/18/2019
Last updated
09/30/2019
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