Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Lisa C Dezelan, PA

Individual provider Physician Assistant · NPI 1063466373

MS. Lisa C Dezelan, PA is a Physician Assistant in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

9200 W Wisconsin Ave Division Of Neoplastic Diseases
Milwaukee, WI 53226-3522
Phone: (414) 805-6800
Fax: (414) 805-6805
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1458 (WI)

Record details

NPI number1063466373
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 20, 2006
Last updated in NPPESDecember 13, 2012

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