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Individual

LISA ELEANOR FAHEY-BLEICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4178 KNOB DR, SUITE A, EAGAN, MN 55122-2888
(651) 209-8640
(651) 209-8690
Mailing address
14010 COBBLER AVE, ROSEMOUNT, MN 55068-7130
(651) 423-1738

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1205765
MN

Other

Enumeration date
06/12/2006
Last updated
02/10/2009
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