Provider Demographics
NPI:1306950209
Name:KEHL, LISA M (RD CD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:KEHL
Suffix:
Gender:F
Credentials:RD CD
Other - Prefix:
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Mailing Address - Street 1:2701 N ONEIDA ST
Mailing Address - Street 2:STE D
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-730-4960
Mailing Address - Fax:920-739-0953
Practice Address - Street 1:2701 N ONEIDA ST
Practice Address - Street 2:STE D
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-730-4960
Practice Address - Fax:920-739-0953
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI172729207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology