Wilson, Lisa M

Wilson, Lisa M is an individual health care provider with primary practice located at 550 N Hillside St , Wichita KS 67214-4910. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Wilson, Lisa M can be contacted via phone (316) 962-8580.

Contact Information

Primary practice address
550 N Hillside St Wichita KS 67214-4910
Phone: (316) 962-8580
Fax: (316) 962-8581
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 45799 Kansas

Profile Details

NPI number 1366551137
LBN Legal business name Wilson, Lisa M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Jul 8th, 2007 - about 17 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 1366551137 NPPES
Kansas MEDICAID 200377070A
Kansas Other 161675

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