LISA LAVONN LONG (NPI# 1801072020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801072020 |
| Entity Type | Individual |
| Full Name | LISA LAVONN LONG |
| Credential | RN CNS |
| Practice Address |
2800 Campus Dr Suite 30 Plymouth MN 55441-2645 |
| Mailing Address |
Division of Vascular Surgery, Mmc 195 420 Delaware Street Se Mmc 195 Minneapolis MN 55455 |
| Practice Telephone | 7633982203 |
| Practice Fax Number | 7633982233 |
| Mailing Telephone | 6126264893 |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2018-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
R1414190 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073808507 | Lisa Long | Psychologist | 1524 Duckworth Ave, Charlotte, NC 28208-4315 | 2011-06-13 |
| 1730331828 | Lisa Sheri Long | Speech-Language Pathologist | 5 Settlers Rdg S, Malta, NY 12020-3755 | 2008-10-21 |
| 1104818731 | Lisa R Long | Chiropractor | 307 E Karsch Blvd, Farmington, MO 63640-1203 | 2005-08-19 |
| 1376015321 | Lisa Marie Long | Occupational Therapy Assistant | 725 Columbus Ave, Fostoria, OH 44830-3255 | 2018-12-31 |
| 1356831572 | Lisa Long | Physician Assistant | 201 Cedar St Se Ste 304, Albuquerque, NM 87106-4932 | 2018-05-14 |
| 1033639380 | Lisa Monique Long | Technician, Other | 1702 N Collins Blvd Ste 250, Richardson, TX 75080-3655 | 2017-06-27 |
| 1174052740 | Lisa C Long | Case Management | 6480 N Star Ln, Paso Robles, CA 93446-7639 | 2017-06-07 |
| 1609323641 | Lisa Long | Pharmacist | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2016-09-07 |
| 1154780864 | Lisa Long | Case Manager/Care Coordinator | 502 Farrell Dr, Covington, KY 41011-3717 | 2016-02-23 |
| 1821401043 | Lisa Michelle Long | Registered Nurse | 512 E Main St, Park Hills, MO 63601-2624 | 2014-06-05 |
| Street Address |
2800 CAMPUS DR SUITE 30 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134509300 | Michele Marie Ducharme Rauma | Nurse Practitioner | 2800 Campus Dr, Suite 20, Plymouth, MN 55441-2645 | 2015-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 364SA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528235488 | Andrea Winick | Clinical Nurse Specialist | 12755 Highway 55, Mn009-s130, Plymouth, MN 55441-3837 | 2008-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069318 | Ann Ruth Loth | Clinical Nurse Specialist | 3826 Halling Pl Sw, Rochester, MN 55902-1667 | 2020-10-05 |
| 1053861146 | Deborah Mangan-danckwart | Clinical Nurse Specialist | 67726 207th Ave, Wabasha, MN 55981-2196 | 2016-10-12 |
| 1215333471 | Jodi Hartwig | Clinical Nurse Specialist | 528 Ashland Ave Apt 3, Saint Paul, MN 55102-2059 | 2014-11-14 |
| 1972860526 | Lifetree Clinic | Clinical Nurse Specialist | 14585 Grand Ave, Suite 206, Burnsville, MN 55306-5719 | 2012-04-20 |
| 1104066695 | Lorene K Brown | Clinical Nurse Specialist | 120 Choctaw Cir, Chanhassen, MN 55317-9505 | 2009-02-24 |
| 1912143751 | Kimberly Kay Ness | Clinical Nurse Specialist | 6545 France Ave S # 210, Edina, MN 55435-2131 | 2008-12-29 |
| 1326234469 | Lyn Marie Palacheck | Clinical Nurse Specialist | 24750 Field Ave, Forest Lake, MN 55025-7214 | 2007-09-21 |
| 1336186048 | Kelli J Simmons | Clinical Nurse Specialist | 420 Delaware Street Southeast, Mayo Mail Code 450, Minneapolis, MN 55455 | 2006-06-01 |
| 1053393967 | Christine M Day | Clinical Nurse Specialist | 1502 London Rd, Suite 102, Duluth, MN 55812-1788 | 2005-11-16 |
| 1386287910 | Sara Beth Roslansky | Clinical Nurse Specialist | 1925 Woodwinds Dr, Woodbury, MN 55125-4445 | 2019-10-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.