Individual
LYLE DAVID WILLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA, PA, ROPA-C
Contact information
Practice address
775 PRAIRIE CENTER DR, SUITE 250, EDEN PRAIRIE, MN 55344-7314
(952) 944-2519
(952) 944-0460
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R0773991
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73B62WI
BLUECROSS BLUESHIELD
—
01
—
969991011727
PREFERREDONE
—
01
—
HP43945
HEALTHPARTNERS
—
Enumeration date
08/23/2006
Last updated
07/11/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us