LISA A KORBAN (NPI# 1932193638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932193638 |
| Entity Type | Individual |
| Full Name | LISA A KORBAN |
| Credential | FNP, APNP |
| Practice Address |
2350 N Lake Dr Suite 400 Milwaukee WI 53211-4528 |
| Mailing Address |
4425 N Port Washington Rd Attn: Csmcp Clinic Credentialing Glendale WI 53212-1082 |
| Practice Telephone | 4142711633 |
| Practice Fax Number | 4142715071 |
| Mailing Telephone | 4142711633 |
| Mailing Fax Number | 4142715071 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2011-11-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2404-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2350 N LAKE DR SUITE 400 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721407 | Nguyen H Phan | Internal Medicine | 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 | 2005-06-22 |
| 1326650698 | Dylan Henry Menefee | Physician Assistant | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2020-08-18 |
| 1659936169 | Cadie Leigh Roszak | Nurse Practitioner | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2019-05-09 |
| 1457884165 | Shelly A. Boyd | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2017-04-10 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1376996397 | Jennifer Gallagher | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-14 |
| 1104285873 | Catherine Bares | Nurse Practitioner | 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 | 2016-02-23 |
| 1578921375 | Heather Bastjan | Nurse Practitioner | 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 | 2016-02-08 |
| 1033586292 | Angela Kraus | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-08-24 |
| 1871974964 | Tatyana Trendafilova Radulovic | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252526 | Moneesha Roy | Nurse Practitioner | 9200 W. Wisconsin Ave, General Internal Medicine- Froedtert Specialty Clinics, Milwaukee, WI 53226 | 2020-07-14 |
| 1376185819 | Courtney Lamm | Nurse Practitioner | 3727 W Wisconsin Ave, Milwaukee, WI 53208-3182 | 2019-10-16 |
| 1366099632 | Megan Abramson | Nurse Practitioner | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2019-08-21 |
| 1093282634 | Kelly Ayala | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2018-11-01 |
| 1114417235 | Rebecca Davina Beznowski | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2018-05-14 |
| 1962901207 | Megan Argall | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2018-02-01 |
| 1912418468 | Molly Barbara Kortsch | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2017-10-23 |
| 1215448501 | Nygil Matthews | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2017-10-13 |
| 1487163184 | Charles Dombeck | Nurse Practitioner | 949 N 9th St, Milwaukee, WI 53233-1422 | 2017-09-25 |
| 1588180582 | Brittany A Fasse | Nurse Practitioner | 9200 W Wisconsin Ave, Froedtert and Medical College of Wisconsin, Milwaukee, WI 53226-3522 | 2017-08-21 |
| Find all providers in MILWAUKEE | ||||
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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.