Individual
LISA A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
635 MAIN ST, GREEN BAY, WI 54301-4918
(920) 593-2465
Mailing address
E3923 PHEASANT RD, ALGOMA, WI 54201-9729
(920) 593-2465
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
162101-30
WI
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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