Individual
LISA CORINA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
S5905 BLACK RIVER RD, VIROQUA, WI 54665-8665
(608) 632-5623
Mailing address
S5905 BLACK RIVER RD, VIROQUA, WI 54665-8665
(608) 632-5623
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18719-33
WI
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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