Provider Demographics
NPI:1982648697
Name:VARNES-EPSTEIN, LISA J (PA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:VARNES-EPSTEIN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:507 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-2059
Mailing Address - Country:US
Mailing Address - Phone:608-624-5203
Mailing Address - Fax:608-638-5039
Practice Address - Street 1:102 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:SOLDIERS GROVE
Practice Address - State:WI
Practice Address - Zip Code:54655-1400
Practice Address - Country:US
Practice Address - Phone:608-624-5203
Practice Address - Fax:608-638-5039
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIS06758Medicare UPIN