Thiltgen, Lisa R

Thiltgen, Lisa R is an individual health care provider with primary practice located at 3329 N Richmond St , Appleton WI 54911-1063. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Thiltgen, Lisa R can be contacted via phone (920) 380-2715.

Contact Information

Primary practice address
3329 N Richmond St Appleton WI 54911-1063
Phone: (920) 380-2715
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209022574 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 11786-33 Wisconsin

Profile Details

NPI number 1609455591
LBN Legal business name Thiltgen, Lisa R
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2021
Last updated Sep 28th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609455591 NPPES
Wisconsin MEDICAID 100209638

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