Healthcare Provider Details

I. General information

NPI: 1467745166
Provider Name (Legal Business Name): LISA M RICHARDS MSN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 FRANK LLOYD WRIGHT AVE SUITE 103
MIDDLETON WI
53562-1753
US

IV. Provider business mailing address

6720 FRANK LLOYD WRIGHT AVE SUITE 103
MIDDLETON WI
53562-1753
US

V. Phone/Fax

Practice location:
  • Phone: 608-821-0123
  • Fax: 608-821-0124
Mailing address:
  • Phone: 608-821-0123
  • Fax: 608-821-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: