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General NPI Number Information
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NPI Number | 1558324780
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Entity Type | Individual
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Provider Name | LISA M VOLLMER MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 280 SMITH AVE N STE 600
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City | SAINT PAUL
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State | MN
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Zip | 55102-2424
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Country | US
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Telephone | 651-241-7246
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Fax | 651-241-7272
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Provider Business Mailing Address
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Address Line | 910 W 32ND ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-3552
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Country | US
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Telephone | 612-964-1494
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41270
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 41270
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License Number State | MN
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