Individual
LISA NOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1650 NEW BRIGHTON BLVD, MINNEAPOLIS, MN 55413-1643
(866) 389-2727
Mailing address
412 3RD AVE NE, MINNEAPOLIS, MN 55413-2276
(901) 848-2392
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12370
MN
Other
Enumeration date
03/10/2017
Last updated
05/05/2020
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