LISA BERNTSON DORNICK PNP NPI 1992743884

NPI Information

NPI: 1992743884
Provider Name: LISA BERNTSON DORNICK, PNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
250 S 4TH ST
MINNEAPOLIS, MN
ZIP 55415
Phone: (612) 673-2301
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Lisa Berntson Dornick, PNP is a pediatrics nurse practitioner in Minneapolis, MN. Lisa Berntson Dornick, PNP NPI is 1992743884. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

250 S 4TH ST
MINNEAPOLIS, MN
ZIP 55415-384
Phone: (612) 673-2301
Fax: (612) 673-3866

The enumeration date for this NPI number is 6/3/2006 and was last updated on 9/21/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	R-101808-8	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	500002662	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
2	782314200	MEDICAID	MINNESOTA
3	P07086	MEDICARE UPIN	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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