LORI KOMISAR (NPI# 1225514656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225514656 |
| Entity Type | Individual |
| Full Name | LORI KOMISAR |
| Credential | RN-BSN |
| Practice Address |
9252 N Green Bay Rd Brown Deer WI 53209-1104 |
| Mailing Address |
9252 N Green Bay Rd Milwaukee WI 53209-1104 |
| Practice Telephone | 4145275261 |
| Mailing Telephone | 4145275261 |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
85501-30 | WI | Nursing Service Providers |
| Street Address |
9252 N GREEN BAY RD |
| City | BROWN DEER |
| State | WI |
| Zip Code | 53209-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669470134 | Soliven C Bautista | Physical Medicine & Rehabilitation | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2005-07-08 |
| 1023644531 | Matthew Michael | Physical Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2020-03-16 |
| 1427517408 | Ascension Wisconsin Pharmacy, Inc. | Pharmacy | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2019-03-18 |
| 1679031629 | Allie Knaus | Physical Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2019-03-08 |
| 1700356557 | Emily M Samuel | Physician Assistant | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2018-12-04 |
| 1891240610 | Nate Sullivan | Nurse Practitioner | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2016-08-22 |
| 1366849952 | Cesar Sison | Occupational Therapist | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2014-11-25 |
| 1518360882 | Amy Prout | Dietitian, Registered | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2014-10-01 |
| 1255512141 | Marina L. Kropp | Physical Medicine & Rehabilitation | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2007-11-19 |
| 1447320510 | Shannon Sarah Muderlak | Family Medicine | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| Taxonomy Code | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376016196 | Georgia Ann Horner | Registered Nurse | 3805a Spring St Ste 311, Mount Pleasant, WI 53405-1600 | 2019-01-03 |
| 1962970350 | Elizabeth Mowbray | Registered Nurse | 36500 Aurora Dr Ste 330, Summit, WI 53066-4899 | 2018-11-05 |
| 1972098697 | Courtney Fagan | Registered Nurse | 3805 Spring Street, Bldg A - Suite 311, Racine, WI 53405-1600 | 2018-06-25 |
| 1659882942 | Linda K Davis | Registered Nurse | 2323 N Lake Dr Rm W2039, Milwaukee, WI 53211-4508 | 2017-10-13 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1255876462 | Rebecca Delain | Registered Nurse | 616 Aurora Dr, Green Bay, WI 54302-4871 | 2016-12-23 |
| 1558688713 | Patricia Jean Celek | Registered Nurse | 8901 W. Lincoln Avenue, Awamc, West Allis, WI 53227 | 2010-04-28 |
| 1952525529 | Sheryl H Ashby | Registered Nurse | 125 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2007-04-12 |
| 1700928850 | Leann Tilden | Registered Nurse | 1818 N. Meade St., Appleton Medical Center, Appleton, WI 54911 | 2007-02-13 |
| 1467078196 | Lynn J Estacio | Registered Nurse | 9000 W Sura Ln, Greenfield, WI 53228-3477 | 2020-06-18 |
| Find all providers with the same taxonomy | ||||
| City | BROWN DEER |
| Zip Code | 53209 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.