Provider Demographics
NPI:1013002385
Name:KUESTER, LISA (RN CPNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KUESTER
Suffix:
Gender:F
Credentials:RN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2317
Mailing Address - Country:US
Mailing Address - Phone:715-379-2927
Mailing Address - Fax:
Practice Address - Street 1:9605 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6380
Practice Address - Country:US
Practice Address - Phone:301-330-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI341-33363L00000X
WI100620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43831700Medicaid
S70475Medicare UPIN