Individual
LISA BENEDETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
14050 FAIRVIEW DR, BURNSVILLE, MN 55337-4571
(952) 993-6500
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
131902-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-07502
MEDICA
MN
01
—
160791
UCARE
MN
01
—
53M23BE
BCBS
MN
05
—
866467600
—
MN
01
—
923911025410
PREFERRED ONE
MN
01
—
HP31623
HEALTH PARTNERS
MN
Enumeration date
04/11/2006
Last updated
04/13/2023
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