Provider Demographics
NPI:1043258866
Name:KROMANAKER, LISA ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ELLEN
Last Name:KROMANAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 GARNET LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-2552
Mailing Address - Country:US
Mailing Address - Phone:608-242-7295
Mailing Address - Fax:608-249-3171
Practice Address - Street 1:4122 E TOWNE BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3732
Practice Address - Country:US
Practice Address - Phone:608-242-6840
Practice Address - Fax:608-242-6117
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI105560163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency