Jennifer Lidbury
Individual provider Active NPI Registered Nurse · Gresham, WI
NPI 1861853566 · NPPES record last updated Mar 9, 2016
Key facts
- NPI
- 1861853566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 169207-30 (WI)
- Practice address
- N2150 Kesaehkahtek
Gresham, WI 54128 - Phone
- (715) 799-3835
- Fax
- (715) 799-5056
- NPI assigned
- Mar 9, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 169207-30 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 169207-30 | WI | Yes |
Addresses
Primary practice location
N2150 Kesaehkahtek
Gresham, WI 54128
Mailing address
N2150 Kesaehkahtek
Gresham, WI 54128
Phone (715) 799-3835
Other providers in Gresham, WI
- Ashley Hebert
- Dominic David Hermann
- Teresa Jean Juga
- Brian A Krause
- Annette Pauline Latender
- Maehnowesekiyah Wellness Center
- Jennifer Mavis
- Nanette Marie Pamonicutt
- Chantelle Panske
- Brandon Waupekenay
All providers in Gresham, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.