Individual
LISA B NEWCOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
9550 UPLAND LN N, SUITE 100, MAPLE GROVE, MN 55369-4481
(763) 537-6000
(763) 537-6666
Mailing address
2104 NORTHDALE BLVD NW, SUITE 220, MINNEAPOLIS, MN 55433-3028
(763) 537-6000
(763) 537-6666
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
1075
MN
363L00000X
Nurse Practitioner
Primary
1075
MN
Other
Enumeration date
11/18/2009
Last updated
02/13/2019
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