Vanwatermulen, Lisa

Vanwatermulen, Lisa is an individual health care provider with primary practice located at 1230 E Main St , Mankato MN 56001-5066. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Vanwatermulen, Lisa can be contacted via phone (507) 625-1811.

Contact Information

Primary practice address
1230 E Main St Mankato MN 56001-5066
Phone: (507) 625-1811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R145777-5 Minnesota

Profile Details

NPI number 1740308527
LBN Legal business name Vanwatermulen, Lisa
Credentials RN, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Sep 28th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740308527 NPPES
Minnesota Other 37M90VA BCBSM
Minnesota Other P00602861 BCBSM
Minnesota MEDICAID 308637300 BCBSM

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