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General NPI Number Information
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NPI Number | 1700255817
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Entity Type | Individual
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Provider Name | LISA NETKOW MSN, APRN
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Gender | Female
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 2500 OVERLOOK TER
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City | MADISON
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State | WI
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Zip | 53705-2254
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Country | US
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Telephone | 608-280-7139
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 OVERLOOK TER
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City | MADISON
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State | WI
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Zip | 53705-2254
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Country | US
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Telephone | 608-280-7139
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Fax | 608-280-7223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP60591630
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 8303
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License Number State | WI
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