Individual
CAROLYN M LISHERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11723 W GLENDALE AVE, WAUWATOSA, WI 53225-4329
(414) 828-7675
Mailing address
11723 W GLENDALE AVE, WAUWATOSA, WI 53225-4329
(414) 828-7675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
91548-030
WI
Other
Enumeration date
07/17/2011
Last updated
07/17/2011
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