Lisa K Brellenthin, APNP
Individual provider Active NPI Nurse Practitioner · Whitewater, WI
NPI 1992087498 · NPPES record last updated Sep 12, 2011
Key facts
- NPI
- 1992087498
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4534-33 (WI)
- Practice address
- 507 W Main St
Whitewater, WI 53190-1852 - Phone
- (262) 473-0400
- Fax
- (262) 473-0408
- NPI assigned
- Sep 12, 2011
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4534-33 | WI | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4534-33 | WI | Yes |
Addresses
Primary practice location
507 W Main St
Whitewater, WI 53190-1852
Mailing address
507 W Main St
Whitewater, WI 53190-1852
Phone (262) 473-0400
Other providers in Whitewater, WI
- Ali Benson
- Nathaniel Stuart Besch
- Ryatisima Tishara Blue
- Lesley Loraine Blum
- Mikayla Lynn Boettner
- Cheryl Bresnahan
- Forrest Lee Bright
- Patricia Lee Bromley
- Brotoloc Inc. Outpatient Clinic
- Brotoloc Inc. Outpatient Clinic
All providers in Whitewater, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2011. 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.