Provider Demographics
NPI:1942568498
Name:MENTAL HEALTH FOR WOMEN MEDICATION MANAGEMENT, LLC
Entity Type:Organization
Organization Name:MENTAL HEALTH FOR WOMEN MEDICATION MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDNER
Authorized Official - Suffix:
Authorized Official - Credentials:APNP
Authorized Official - Phone:608-697-8530
Mailing Address - Street 1:N6326 RAVEN RD
Mailing Address - Street 2:
Mailing Address - City:PARDEEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53954-9579
Mailing Address - Country:US
Mailing Address - Phone:608-697-8530
Mailing Address - Fax:877-765-0576
Practice Address - Street 1:1250 FEMRITE DR STE 205B
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3787
Practice Address - Country:US
Practice Address - Phone:608-697-8530
Practice Address - Fax:877-765-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1042-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty