Healthcare Provider Details

I. General information

NPI: 1407088065
Provider Name (Legal Business Name): LISA LYNN TURBES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S 5TH ST SUITE 119H
OLIVIA MN
56277-1374
US

IV. Provider business mailing address

105 S 5TH ST SUITE 119H
OLIVIA MN
56277-1374
US

V. Phone/Fax

Practice location:
  • Phone: 320-579-0050
  • Fax: 320-523-3749
Mailing address:
  • Phone: 320-579-0050
  • Fax: 320-523-3749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR161000-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: