Individual
LAUREN NICOLE LISOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 W 140TH ST UNIT 201, BURNSVILLE, MN 55337-4833
(952) 808-3000
(952) 808-3001
Mailing address
3500 AMERICAN BLVD W STE 300, BLOOMINGTON, MN 55431-4442
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14981
MN
Other
Enumeration date
04/11/2023
Last updated
07/17/2024
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