Individual
MRS. LISA A SHRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1055 WESTGATE DR, SUITE 100, SAINT PAUL, MN 55114-1065
(612) 262-7517
Mailing address
2746 BROCKMAN CT, NORTHFIELD, MN 55057-3438
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
A0811106
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
G0911005
MN
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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