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Contact Information

LISETTE C BROWN, PA C
421 CAMELOT DR
FOND DU LAC, WI54935
 Phone: 920-926-8500
 Fax: 920-926-8983
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LISETTE C BROWN · (Female)

NPI Number 1578597035
Status Active
Credentials PA C
Entity Individual
Enumeration date 07/10/2006
Last updated 04/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1623023
  • WI Medicaid 41993300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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