Sershon, Lisa M

Sershon, Lisa M is an individual health care provider with primary practice located at 975 Port Washington Rd , Grafton WI 53024-9201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Sershon, Lisa M can be contacted via phone (262) 329-1000.

Contact Information

Primary practice address
975 Port Washington Rd Grafton WI 53024-9201
Phone: (262) 329-1000
Fax: (262) 329-1001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2854-23 Wisconsin

Profile Details

NPI number 1245514702
LBN Legal business name Sershon, Lisa M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2011
Last updated Jan 4th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245514702 NPPES
Wisconsin MEDICAID 100017857

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