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Individual

LISA M BENISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
790 W 66TH ST, RICHFIELD, MN 55423-2203
(612) 873-6963
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
(651) 222-1305

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9642
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0120453
MEDICA
MN
05
044599100
MN
01
141859
UCARE
MN
01
348S4BE
BCBS
MN
01
HP35662
HEALTH PARTNERS
MN
01
NA9021034915
PREFERRED ONE
MN
Enumeration date
03/31/2006
Last updated
08/11/2025
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