Gouthro, Lisa

Gouthro, Lisa is an sole proprietor health care provider with primary practice located at 3981 S Victoria Ct , New Berlin WI 53151-9002. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Gouthro, Lisa can be contacted via phone (262) 797-8358.

Contact Information

Primary practice address
3981 S Victoria Ct New Berlin WI 53151-9002
Phone: (262) 797-8358
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 0128903-030 Wisconsin

Profile Details

NPI number 1265568968
LBN Legal business name Gouthro, Lisa
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2007
Last updated Mar 21st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265568968 NPPES
Wisconsin MEDICAID 38236100

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