Look up the most recent NPI and PECOS records

Lisa Marie Brandt

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy Ste 680, Milwaukee, WI 53215-3633

(414) 385-1922 (414) 243-6991

PECOS Enrollment

This provider is enrolled in PECOS as LISA BRANDT.

Based on the most recent information from CMS, provider Lisa Marie Brandt is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1629615570
Provider Type
Individual
Full Name
Brandt, Lisa Marie
Title
Dr.

Gender
Female
Sole Proprietor
No
Enumeration Date
12/10/2019
Last Updated
11/24/2021

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy Ste 680, Milwaukee, WI 53215-3633

(414) 385-1922

(414) 385-1899

Mailing Location

12860 Pinewood Rd, Brookfield, WI 53005-3843

(414) 243-6991

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 9591-33 Wisconsin

Lisa Marie Brandt

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ozzello, Allysa

Kwasinski, Ashley L

Masaka, Kimiyo M

Stumvoll, Diane M

Solomon, Sharon Jean

Freeland, Kathleen A

Martin, Stephanie R

Goelz, Jessica F

Wollner, Tanya

Malone, Anna Tai