Individual
MISTY B LESNJAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213
(414) 773-4312
(414) 454-6522
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7799
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7799
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070115
—
WI
05
—
100070157
—
WI
Enumeration date
07/13/2017
Last updated
11/20/2023
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