LISETTE C BROWN (NPI# 1578597035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578597035 |
| Entity Type | Individual |
| Full Name | LISETTE C BROWN |
| Credential | PA C |
| Practice Address |
421 Camelot Dr Fond Du Lac WI 54935 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209268500 |
| Practice Fax Number | 9209268983 |
| Mailing Telephone | 9209268340 |
| Mailing Fax Number | 9209268370 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1623023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41993300 | 05 |
| Street Address |
421 CAMELOT DR |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366433435 | Elizabeth S Bensen | Physical Medicine & Rehabilitation | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2005-10-28 |
| 1962028522 | Kelley Cantu | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-06-19 |
| 1306473780 | Samantha Jo Krones | Physician Assistant | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-03-25 |
| 1962975292 | Tyler Schwarz | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2019-01-09 |
| 1154808491 | Greta Marie Breckbill | Audiologist | 421 Camelot Dr, Fond Du Lac, WI 54935 | 2018-07-19 |
| 1861991424 | Jacklyn Osborne | Nurse Practitioner | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2018-02-08 |
| 1932620689 | Michael Schraufnagel | Physical Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-07-03 |
| 1477083608 | Tristan G Brown | Optometrist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-06-20 |
| 1306379433 | Ashley Beyer | Specialist/Technologist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-04-05 |
| 1417498254 | Allieson Elizabeth Mirsberger | Massage Therapist | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473780 | Samantha Jo Krones | Physician Assistant | 421 Camelot Dr, Fond Du Lac, WI 54935-8335 | 2020-03-25 |
| 1447739032 | Kelsey R Renn | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2018-08-14 |
| 1255823316 | Teegan R Kraus | Physician Assistant | 420 E Division St, Fond Du Lac, WI 54935 | 2018-06-05 |
| 1720575749 | Anna Clare Hang | Physician Assistant | 912 S Hickory St, Fond Du Lac, WI 54935-5530 | 2018-04-16 |
| 1528519758 | Betty Xiong | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-10-24 |
| 1679926596 | Nicole A Merz | Physician Assistant | 912 S Hickory St, Fond Du Lac, WI 54935 | 2016-07-15 |
| 1942652466 | Nicole K Stuckart | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2016-07-08 |
| 1063884450 | Alexander Engel | Physician Assistant | 145 N Main St, Fond Du Lac, WI 54935-3423 | 2015-10-23 |
| 1548667231 | Tanya Watry | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2014-11-25 |
| 1326456807 | Cynthia Nicole Wittwer | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2014-07-28 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.