LISA JO LIEDKE (NPI# 1336783042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336783042 |
| Entity Type | Individual |
| Full Name | LISA JO LIEDKE |
| Other Name | LISA JO LEFEBER |
| Practice Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209265666 |
| Mailing Telephone | 9209265666 |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0106X |
Nurse Practitioner Specialization: Occupational Health |
9728 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
420 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489017 | Ronald Eric Lilly | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-01 |
| 1831715721 | Agnesian Healthcare Inc | Preventive Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-17 |
| 1932740495 | Terrina Kay Goeden | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-10-04 |
| 1801441910 | Courtney M Yenter | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-08-06 |
| 1861046591 | Kimberly Kay Hornes | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-31 |
| 1023662459 | Domenick Tirabassi Iv | Student in an Organized Health Care Education/Training Program | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-24 |
| 1497308233 | Kelly Jo Rehfeldt | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-22 |
| 1184286411 | Carley Jo Reinke | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-08 |
| 1255823316 | Teegan R Kraus | Physician Assistant | 420 E Division St, Fond Du Lac, WI 54935 | 2018-06-05 |
| 1265964233 | Robin A Strauss | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2017-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 363LX0106X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Occupational Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659858181 | Tanya Lalk | Nurse Practitioner | 201 N Mayfair Rd Ste 550, Wauwatosa, WI 53226-4216 | 2018-07-27 |
| 1215177175 | Diane Elizabeth Daugharty | Nurse Practitioner | 2100 Winchester Rd, Neenah, WI 54956-9317 | 2009-03-04 |
| 1528449568 | Jenna Lease | Nurse Practitioner | W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2015-06-16 |
| 1164850780 | Jennifer Schaffer | Nurse Practitioner | 180 Gateway Dr, Waupun, WI 53963-2276 | 2013-10-16 |
| 1497952410 | Yvonne T Nelson | Nurse Practitioner | 3021 Voyager Dr, Green Bay, WI 54311-8303 | 2007-07-02 |
| 1922002435 | Joni L Nalli | Nurse Practitioner | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-13 |
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.