Individual
LISA ANNE DOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6055 NATHAN LN N, PLYMOUTH, MN 55442-1674
(763) 513-4392
Mailing address
1124 10TH AVE, GRANITE FALLS, MN 56241-1231
(507) 430-9215
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R1319981
MN
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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