Haller, Lisa
Haller, Lisa is an individual health care provider with primary practice located at 5650 N Green Bay Ave Ste 210 , Glendale WI 53209-4447. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Haller, Lisa can be contacted via phone (414) 431-5971.Contact Information
Primary practice address
5650 N Green Bay Ave Ste 210
Glendale WI 53209-4447
Phone: (414) 431-5971
Fax: (414) 434-0354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 43090 | Wisconsin |
Profile Details
| NPI number | 1245204858 |
|---|---|
| LBN Legal business name | Haller, Lisa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Feb 9th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245204858 | NPPES |
| Wisconsin | MEDICAID | 34072700 |
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