Provider Demographics
NPI:1043686538
Name:ENGELHARDT, LISA M (APNP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:ENGELHARDT
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
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Mailing Address - Street 1:444 N WESTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-5715
Mailing Address - Country:US
Mailing Address - Phone:920-750-7000
Mailing Address - Fax:920-364-2451
Practice Address - Street 1:444 N WESTHILL BLVD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-5715
Practice Address - Country:US
Practice Address - Phone:920-750-7000
Practice Address - Fax:920-364-2451
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI6570-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health