Lisa Hollett, RN

Individual provider Active NPI Nursing Care Agency · Baraboo, WI

NPI 1972960656 · NPPES record last updated Jan 26, 2016

Key facts

NPI
1972960656
Entity type
Individual (NPI type 1)
Primary specialty
Nursing Care Agency 251J00000X
License
139554-30 (WI)
Practice address
S2124 Pine View CT
Baraboo, WI 53913-8700
Phone
(608) 432-1102
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
139554-30WIMDCase Management Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 139554-30 WI
Nursing Care Agency 251J00000X 139554-30 WI Yes

Addresses

Primary practice location

S2124 Pine View CT
Baraboo, WI 53913-8700

Mailing address

S2124 Pine View CT
Baraboo, WI 53913-8700
Phone (608) 432-1102

Other providers in Baraboo, WI

All providers in Baraboo, WI · Nursing Care Agency in Wisconsin

Sources for this page

Verify at the official NPI Registry.