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NPI 1245463199

IndividualActive

Amy Tisdale, LPN

NPI 1245463199 · Licensed Practical Nurse · Waupun, WI

Provider details

NPI number: 1245463199
Entity type: Individual
Primary specialty: Licensed Practical NurseNursing Service Providers
Credential: LPN
Sex: Female
Sole proprietor: No
License: 33107031 (WI)

Practice location

509 Maxon St

Waupun, WI 53963-1952

Phone: (920) 324-3467

More WI providers

Mailing address

509 Maxon St

Waupun, WI 53963-1952

Registry dates

Enumerated: 2009-08-26
Last updated: 2009-08-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Amy Tisdale, LPN — NPI 1245463199, Waupun, WI | NPI Central