Individual
MS. LISA MARIE NASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 275-3325
Mailing address
8170 33RD AVE, MS: 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1427
WI
363AM0700X
Medical Physician Assistant
Primary
10110
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201770900
—
MN
05
—
41933300
—
WI
Enumeration date
12/14/2005
Last updated
05/31/2022
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