Bullis, Lisa Marie
Bullis, Lisa Marie is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Bullis, Lisa Marie can be contacted via phone (414) 955-0728.Contact Information
Primary practice address
9200 W Wisconsin Ave
Milwaukee WI 53226-3522
Phone: (414) 955-0728
Fax: (414) 805-4606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 195913-30 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 9484-33 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 9484 | Wisconsin |
Profile Details
| NPI number | 1558922492 |
|---|---|
| LBN Legal business name | Bullis, Lisa Marie |
| Credentials | MSN, APNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2019 |
| Last updated | Jul 19th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558922492 | NPPES |
| Wisconsin | MEDICAID | 100092474 | |
| Wisconsin | Other | 195913-30 | |
| Wisconsin | Other | 9484-33 |
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