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NPI Code Detail

MEDICARE: LISA MARIE ZALLAR CNP

MEDICARE: LISA MARIE ZALLAR CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3032MN

General Provider Information

NPI Number : 1831381193
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE ZALLAR CNP
Provider Business Mailing Address
First Line : 6351 E SUPERIOR ST
Second Line :
City : DULUTH
State : MN
Zip : 55804-2545
Country : US
Telephone Number : 218-249-5555
Fax Number :
Provider Business Practice Location Address
First Line : 6351 E SUPERIOR ST
Second Line :
City : DULUTH
State : MN
Zip : 55804-2545
Country : US
Telephone Number : 218-249-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2007
Last Update Date : 07/06/2022

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