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NPI Code Detail

MEDICARE: LISA WILLMS CD(DONA)

MEDICARE: LISA WILLMS CD(DONA)
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374J00000XDoulaMN

General Provider Information

NPI Number : 1952851677
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WILLMS CD(DONA)
Provider Business Mailing Address
First Line : 120 DEMONT AVE E APT 102
Second Line :
City : LITTLE CANADA
State : MN
Zip : 55117-1528
Country : US
Telephone Number : 612-353-6293
Fax Number :
Provider Business Practice Location Address
First Line : 1121 JACKSON ST NE STE 100
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3051
Country : US
Telephone Number : 612-353-6293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2016
Last Update Date : 02/26/2024

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Directions to “ LISA WILLMS CD(DONA)” Practice Location

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