Provider Demographics
NPI:1386602811
Name:SCHABLA, LISA M (PA SPECIALIST)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SCHABLA
Suffix:
Gender:F
Credentials:PA SPECIALIST
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Mailing Address - Street 1:4202 W OAKWOOD PARK CT
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9118
Mailing Address - Country:US
Mailing Address - Phone:414-855-2800
Mailing Address - Fax:414-855-2801
Practice Address - Street 1:4202 W OAKWOOD PARK CT
Practice Address - Street 2:SUITE 120
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9118
Practice Address - Country:US
Practice Address - Phone:414-855-2800
Practice Address - Fax:414-855-2801
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2017-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI904-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI001301755Medicare ID - Type Unspecified