Lubbers, Lisa Annette
Lubbers, Lisa Annette is an individual health care provider with primary practice located at 6500 Excelsior Blvd , St Louis Park MN 55426-4702. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Lubbers, Lisa Annette can be contacted via phone (952) 993-5000.Contact Information
Primary practice address
6500 Excelsior Blvd
St Louis Park MN 55426-4702
Phone: (952) 993-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Neonatal | 363LN0000X | R160724-0 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | CNP1136 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Neonatal | 363LN0000X | CP000374 | South Dakota |
Profile Details
| NPI number | 1093838963 |
|---|---|
| LBN Legal business name | Lubbers, Lisa Annette |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2007 |
| Last updated | May 7th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093838963 | NPPES |
| Minnesota | Other | R 160724-0 | MN RN |
| Minnesota | Other | R0287659 | MN RN |
| Minnesota | Other | LUB1-0430-2308 | MN RN |
| Minnesota | MEDICAID | 6829300 | MN RN |
| Minnesota | Other | 9254403 | MN RN |
| Minnesota | Other | 4993173 | MN RN |
| Minnesota | Other | CP000374 | MN RN |
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