Healthcare Provider Details

I. General information

NPI: 1568102374
Provider Name (Legal Business Name): LISA MARIE KALSCHEUR DNP, APNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA MARIE TROIA

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 S STOUGHTON RD
MADISON WI
53716-2257
US

IV. Provider business mailing address

1821 S STOUGHTON RD
MADISON WI
53716-2257
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-6000
  • Fax: 608-260-6451
Mailing address:
  • Phone: 608-260-6000
  • Fax: 608-260-6451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11587-33
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11587
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: