Lisa Marie Fargo, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Practice address

334 Justin Dr
Mount Horeb, WI 53572-2199

Phone

(608) 437-4220

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1609845692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 JUSTIN DR",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535723306",
            "telephone_number": "608-437-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 JUSTIN DR",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535722199",
            "telephone_number": "608-437-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARGO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis J Dignan
• Cynthia Marie Doran, PHARMD, BCPS
• Dreamweaver Anesthesia, LLC
• Timothy D Drews, MD
• Anne R Eglash, MD
• Gordon Faulkner, MD
• Cheyenne Jannel Goodwin, RN
• Courtney Mae Hanko, PTA
• Amanda C Hatch, D.D.S
• Morgan Heinen

• Licensed Practical Nurse in Mount Horeb, WI
• Providers in Mount Horeb, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.