Individual
MS. LISA SMITH BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 VETERANS DR, 111C, MINNEAPOLIS, MN 55417-2309
(612) 467-3647
(612) 727-5668
Mailing address
5352 HAMPSHIRE DR, MINNEAPOLIS, MN 55419-1433
(612) 824-6129
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
101504-9
MN
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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