Provider Demographics
NPI:1316517824
Name:YORK, LISA J (APNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:YORK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 W RAWSON AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8892
Mailing Address - Country:US
Mailing Address - Phone:414-339-6289
Mailing Address - Fax:
Practice Address - Street 1:3111 W RAWSON AVE STE 235
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8892
Practice Address - Country:US
Practice Address - Phone:414-339-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI175735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily