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NPI Code Detail

MEDICARE: MRS. CARISSA MARIE NEUMAN A-GNP

MEDICARE: MRS. CARISSA MARIE NEUMAN A-GNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner10378-33WI

General Provider Information

NPI Number : 1467068031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARISSA MARIE NEUMAN A-GNP
Provider Business Mailing Address
First Line : N20W22961 WATERTOWN RD
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-1308
Country : US
Telephone Number : 262-875-5070
Fax Number : 866-384-9486
Provider Business Practice Location Address
First Line : N20W22961 WATERTOWN RD
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-1308
Country : US
Telephone Number : 262-875-5070
Fax Number : 866-384-9486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2020
Last Update Date : 10/10/2025

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