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Individual

MS. LISA I WOLFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
516 DELAWARE ST SE, CLINIC 1A, MINNEAPOLIS, MN 55455-0356
(612) 624-6666
(612) 624-0644
Mailing address
420 DELAWARE ST SE, MMC 96 - NEUROSURGERY CLINIC, MINNEAPOLIS, MN 55455-0341
(612) 624-6666

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R124435-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006000215R
HUMANA
05
43909700
WI
Enumeration date
05/16/2006
Last updated
10/28/2013
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