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General NPI Number Information
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NPI Number | 1851362214
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Entity Type | Individual
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Provider Name | LISA YVONNE BATCHELOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 12000 ELM CREEK BLVD N SUITE 250
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City | MAPLE GROVE
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State | MN
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Zip | 55369-7073
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Country | US
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Telephone | 952-401-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 3925 OTTAWA AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-3017
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Country | US
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Telephone | 952-926-7900
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Fax | 952-380-5371
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 41060
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License Number State | MN
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