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General NPI Number Information
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NPI Number | 1265907083
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Entity Type | Individual
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Provider Name | LILLIA BUDD CNP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 225 SMITH AVE N - SUITE 400 MAIL ROUTE 65400
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City | SAINT PAUL
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State | MN
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Zip | 55102
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Country | US
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Telephone | 651-241-2785
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Fax |
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Provider Business Mailing Address
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Address Line | 625 E NICOLLET BLVD STE 203
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City | BURNSVILLE
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State | MN
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Zip | 55337-6735
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Country | US
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Telephone | 612-269-3929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6167
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License Number State | MN
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