AMY LYNN LISDAHL


Address: 1500 N 34th St Ste 100, Superior, WI 54880-4476
Phone: 7153928216

AMY LYNN LISDAHL (NPI# 1700123973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700123973
Entity Type Individual
Full Name AMY LYNN LISDAHL
Credential PMHNP
Practice Address 1500 N 34th St Ste 100
Superior
WI 54880-4476
Mailing Address 1401 E 1st St
Duluth
MN 55805-2407
Practice Telephone 7153928216
Practice Fax Number 7153926055
Mailing Telephone 2187284491
Mailing Fax Number 2187302367
Enumeration Date 2013-01-08
Last Update Date 2020-10-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 606806 CA Nursing Service Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
CNP4944 MN Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
7410 WI Physician Assistants & Advanced Practice Nursing Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
95002695 CA Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1401 E 1st St, Duluth, MN 558052407 2187284491 2187302367

Office Location

Street Address 1500 N 34TH ST STE 100
City SUPERIOR
State WI
Zip Code 54880-4476

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407021579 Human Development Center Case Management 1500 N 34th St Ste 100, Superior, WI 54880-4476 2008-04-29
1700344009 Emily Weber Case Manager/Care Coordinator 1500 N 34th St Ste 100, Superior, WI 54880-4476 2019-03-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104427194 Alana Catherine Sullivan Speech-Language Pathologist 25 N 25th Street E, Superior, WI 54880 2020-11-05
1710524970 Sean Wiberg Peterson Specialist/Technologist 1810 Catlin Ave, Room 1246, Superior, WI 54880 2019-12-06
1558858936 Brent Adam Engstrom Student in an Organized Health Care Education/Training Program 1410 Nth 23rd Street, Superior, WI 54880 2018-04-20
1558769125 David Kroll Specialist Balknap & Catlin Aves., Superior, WI 54880 2014-12-15
1154670321 Superior Treatment Center, Inc Community/Behavioral Health 1507 Tower Ave Ste 307, Superior, WI 54880 2012-09-04
1548551658 Dionne Jeannine Corcoran Midwife 916 Hammond Ave Ste 222, Superior, WI 54880 2011-04-22
1821235433 Lauren Ashley Miller Speech-Language Pathologist 35 N. 28th Street, Superior, WI 54880 2009-01-20
1528261989 Stacy Ann Kennelly Physical Therapist 1612 N 37th Street, Superior, WI 54880 2007-06-06
1760564942 James Henry Dobis Family Medicine 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 2006-10-19
1134214398 Kevin M Mikel Dentist 3312 Tower Avenue, Superior, WI 54880 2006-10-04
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881857167 Holly Lynn Gomez-levine Nurse Practitioner 3500 Tower Ave, Superior, WI 54880-4491 2008-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1003422726 Wisconsin Healthcare Family Practices and Behavioral Services LLC Nurse Practitioner 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 2020-09-17
1689292856 Julianne Margaret John Nurse Practitioner 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 2020-07-13
1356968002 Marisa Hiley Nurse Practitioner W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 2020-06-29
1932726700 Lauren Marie Skemp Nurse Practitioner 1960 Hyview Rd, Cuba City, WI 53807-9718 2020-06-28
1235779240 Conscious Practice, LLC Nurse Practitioner 119 19th St N, La Crosse, WI 54601-3724 2020-01-08
1073152161 Stephanie L Ruskell Nurse Practitioner 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 2020-01-06
1558924811 Sarah Kathryn Garven Nurse Practitioner 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 2019-04-22
1104394535 Therese Ann Alm Nurse Practitioner 383 Williamstowne Ste 101, Delafield, WI 53018-2332 2018-11-03
1477079242 Aeron Rachel Adams Nurse Practitioner W10237 Lake Emily Rd, Fox Lake, WI 53933 2017-08-14
1396140398 Monica Gorski Nurse Practitioner 505 King St Ste 218, La Crosse, WI 54601-4289 2014-11-03
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Competitor

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City SUPERIOR
Zip Code 54880

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Dataset Information

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.

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