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General NPI Number Information
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NPI Number | 1316804040
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Entity Type | Organization
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Legal Business Name | LILAC PSYCHIATRY LLC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 2625 S GREELEY ST STE 356
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City | MILWAUKEE
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State | WI
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Zip | 53207-2024
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Country | US
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Telephone | 414-644-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 2625 S GREELEY ST STE 356
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City | MILWAUKEE
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State | WI
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Zip | 53207-2024
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Country | US
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Telephone | 414-644-0006
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LISA M.S. KUZMA
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Credential | MSN, APNP, PMHNP-BC
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Telephone | 414-644-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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