Individual
LISA A WACHHOLZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
451 JUNCTION RD, MADISON, WI 53717
(608) 263-0150
(608) 833-6932
Mailing address
8007 EXCELSIOR DR, MADISON, WI 53717
(608) 829-5247
(608) 833-6932
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
57828
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39900700
—
WI
Enumeration date
03/16/2006
Last updated
07/08/2007
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