LISA BRENNAN FNP
NPI 1417628702
Nurse Practitioner - Family in Fond Du Lac, WI

Q: What is Lisa Brennan's NPI number?

The NPI number for Lisa Brennan is 1417628702. It was assigned to this individual provider in the NPPES registry on September 25, 2021.

Q: What is Lisa Brennan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Brennan was last updated on September 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 25, 2021PECOS Enrolled

912 S HICKORY ST, FOND DU LAC, WI 54935(920) 907-3922 Get Directions Write a Review

NPPES record last updated: September 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lisa Brennan Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA BRENNAN FNP (NPI 1417628702) is an individual family provider in Fond Du Lac, Wisconsin, licensed in Wisconsin (11148-33) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417628702

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA BRENNANCredential: FNP

Location Address912 S HICKORY STFond Du Lac, WI 54935-5530

Mailing Address1964 Chippewa CtGrafton, WI 53024-2833 · (262) 618-4075

Phone(920) 907-3922

Sole ProprietorNo

Enumeration DateSeptember 25, 2021

NPPES CertifiedSeptember 25, 2021

✔ NPI 1417628702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WI · 11148-33

912 S HICKORY ST, Fond Du Lac, WI 54935

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Brennan Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54935 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEFANIE MAE PETRIE APNP

Nurse Practitioner (Family)