Individual
LISA MCGOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 1ST AVE NE, BUFFALO, MN 55313-1568
(763) 682-3005
(763) 682-3006
Mailing address
1250 72ND AVE NE, APT 106, FRIDLEY, MN 55432-3561
(763) 607-5188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
224477-0
MN
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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