Healthcare Provider Details

I. General information

NPI: 1578912945
Provider Name (Legal Business Name): LISA KAY PARROTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA KAY NIPSTAD RN

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 HIGHWAY 33
SAGINAW MN
55779-9662
US

IV. Provider business mailing address

5231 HIGHWAY 33
SAGINAW MN
55779-9662
US

V. Phone/Fax

Practice location:
  • Phone: 218-591-2276
  • Fax:
Mailing address:
  • Phone: 218-591-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR139137-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: