NPI 1992743884 · live from the CMS NPI Registry
Lisa Berntson Dornick, PNP
Nurse Practitioner, Pediatrics in Minneapolis, MN. National Provider Identifier 1992743884, active.
NPI record
| NPI | 1992743884 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 250 S 4th St, Minneapolis, MN 55415 |
| Practice phone | 612-673-2301 |
| Mailing address | 250 S 4th St, Room 250, Minneapolis, MN 55415 |
| Enumerated | June 3, 2006 |
| Last updated | September 21, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | R-101808-8 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.