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NPI Code Detail

MEDICARE: LORI BIESECKER RN

MEDICARE: LORI BIESECKER RN
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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse107540-30WI

General Provider Information

NPI Number : 1356649099
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI BIESECKER RN
Provider Business Mailing Address
First Line : 3440 OAKWOOD HILLS PKWY
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54701-7698
Country : US
Telephone Number : 715-214-2525
Fax Number :
Provider Business Practice Location Address
First Line : 3440 OAKWOOD HILLS PKWY
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54701-7698
Country : US
Telephone Number : 715-214-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2011
Last Update Date : 01/08/2016

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