Individual
LISA MICHELLE MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
921 GREELEY ST S, STILLWATER, MN 55082-5935
(651) 439-1234
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(952) 883-7165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1432-023
WI
363A00000X
Physician Assistant
Primary
15820
MN
Other
Enumeration date
06/12/2006
Last updated
08/11/2026
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