Campbell, Lisa Lynne Butenhoff
Campbell, Lisa Lynne Butenhoff is an individual health care provider with primary practice located at 1400 Scheuring Rd , De Pere WI 54115-1067. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Campbell, Lisa Lynne Butenhoff can be contacted via phone (920) 964-0229.Contact Information
Primary practice address
1400 Scheuring Rd
De Pere WI 54115-1067
Phone: (920) 964-0229
Fax: (920) 686-9674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD430734 | Pennsylvania |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 4301105435 | Michigan |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 50518-20 | Wisconsin |
Profile Details
| NPI number | 1124145040 |
|---|---|
| LBN Legal business name | Campbell, Lisa Lynne Butenhoff |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2007 |
| Last updated | Aug 21st, 2023 - about last year |
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 | 1124145040 | NPPES |
| Wisconsin | Other | 171400016 | MEDICARE |
| Wisconsin | MEDICAID | 1124145040 | MEDICARE |
| Wisconsin | Other | 382000020 | MEDICARE |
| Wisconsin | Other | 50518-020 | MEDICARE |
| Wisconsin | Other | P00720349 | MEDICARE |
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