Gunderson, Lisa

Gunderson, Lisa is an individual health care provider with primary practice located at 2005 Midway Rd , Menasha WI 54952-7002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gunderson, Lisa can be contacted via phone (920) 832-8500.

Contact Information

Primary practice address
2005 Midway Rd Menasha WI 54952-7002
Phone: (920) 832-8500
Fax: (920) 993-2919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 518-033 Wisconsin

Profile Details

NPI number 1558379909
LBN Legal business name Gunderson, Lisa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558379909 NPPES
Wisconsin MEDICAID 43955700

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