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Individual

LISA MARIA PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1155 N HONEY CREEK PKWY, WAUWATOSA, WI 53213-3189
(414) 615-5900
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11220-33
WI
363LF0000X
Family Nurse Practitioner
11220-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100238877
WI
Enumeration date
10/05/2021
Last updated
02/10/2025
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