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Individual

JENNIFER A LISOWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 288-3443
(507) 529-6622
Mailing address
5067 55TH ST NW, ROCHESTER, MN 55901-3809
(507) 288-3443
(507) 529-6622

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
41670
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
685224600
MN
Enumeration date
03/26/2006
Last updated
03/04/2014
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