Individual
LYDIA SIRUCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
8611 E POINT DOUGLAS RD, COTTAGE GROVE, MN 55016
(651) 458-1884
Mailing address
8611 E POINT DOUGLAS RD, COTTAGE GROVE, MN 55016
(651) 458-1884
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP2096
MN
363LF0000X
Family Nurse Practitioner
Primary
2096
MN
Other
Enumeration date
09/29/2014
Last updated
11/10/2020
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