Healthcare Provider Details

I. General information

NPI: 1619814506
Provider Name (Legal Business Name): ROSALYNN JUDITH LAKEMAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 BUNKER LAKE BLVD NW STE 200
ANDOVER MN
55304-4008
US

IV. Provider business mailing address

11880 LONDON ST NE
BLAINE MN
55449-5416
US

V. Phone/Fax

Practice location:
  • Phone: 763-413-6934
  • Fax: 763-450-3101
Mailing address:
  • Phone: 763-226-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7439
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: