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LISA ANNETTE LUBBERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-5000
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP1136
MN
363LN0000X
Neonatal Nurse Practitioner
CP000374
SD
363LN0000X
Neonatal Nurse Practitioner
R160724-0
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4993173
WELLMARK
SD
05
6829300
SD
01
9254403
DAKOTACARE
SD
01
CP000374
CNP LICENSE
SD
01
LUB1-0430-2308
NCC ID
SD
01
R 160724-0
MN RN
MN
01
R0287659
RN LICENSE
SD
Enumeration date
04/07/2007
Last updated
05/07/2024
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