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General NPI Number Information
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NPI Number | 1932180973
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Entity Type | Individual
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Provider Name | LISA MARY GALL NP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 35294 LOGAN LN
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City | HILLMAN
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State | MN
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Zip | 56338-2445
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Country | US
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Telephone | 320-277-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 35294 LOGAN LANE
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City | HILLMAN
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State | MN
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Zip | 56338
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Country | US
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Telephone | 320-630-9116
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R1085286
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | R1085286
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R1085286
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R1085286
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License Number State | MN
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