Individual
LISA MARIE TERHAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
550 62ND ST, CIRCLE PINES, MN 55014-1442
(612) 406-7200
Mailing address
550 62ND ST, LINO LAKES, MN 55014-1442
(612) 406-7200
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R 124303-1
MN
363LG0600X
Gerontology Nurse Practitioner
R124303
MN
Other
Enumeration date
12/08/2010
Last updated
05/24/2021
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