Haller, Lisa

Haller, Lisa is an individual health care provider with primary practice located at 5650 N Green Bay Ave Ste 210 , Glendale WI 53209-4447. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Haller, Lisa can be contacted via phone (414) 431-5971.

Contact Information

Primary practice address
5650 N Green Bay Ave Ste 210 Glendale WI 53209-4447
Fax: (414) 434-0354
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 43090 Wisconsin

Profile Details

NPI number 1245204858
LBN Legal business name Haller, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Feb 9th, 2022 - about 2 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 1245204858 NPPES
Wisconsin MEDICAID 34072700

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