Individual
KRISTEN EMILY LEWICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
10705 TOWN SQUARE DR NE, BLAINE, MN 55449-8184
(763) 236-5400
Mailing address
2027 141ST AVE NE, HAM LAKE, MN 55304-6551
(651) 338-4027
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3273
MN
363LF0000X
Family Nurse Practitioner
F0712464
MN
Other
Enumeration date
08/20/2012
Last updated
11/10/2020
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