Lisa Lavonn Long, RN CNS | |
2800 Campus Dr, Suite 30, Plymouth, MN 55441-2645 | |
(763) 398-2203 | |
(763) 398-2233 |
Full Name | Lisa Lavonn Long |
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Gender | Female |
Speciality | Clinical Nurse Specialist - Adult Health |
Location | 2800 Campus Dr, Plymouth, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801072020 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
364SA2200X | Clinical Nurse Specialist - Adult Health | R1414190 (Minnesota) | Primary |
Entity Name | University Of Minnesota Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477598118 PECOS PAC ID: 9830001189 Enrollment ID: O20031104000532 |
Entity Name | West Imaging Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053311399 PECOS PAC ID: 7315833720 Enrollment ID: O20040429001479 |
Entity Name | Fairview Express Care |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
Mailing Address | Practice Location Address |
---|---|
Lisa Lavonn Long, RN CNS Division Of Vascular Surgery, Mmc 195, 420 Delaware Street Se Mmc 195, Minneapolis, MN 55455 Ph: (612) 626-4893 | Lisa Lavonn Long, RN CNS 2800 Campus Dr, Suite 30, Plymouth, MN 55441-2645 Ph: (763) 398-2203 |
Andrea Winick, RN, CNP Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 12755 Highway 55, Mn009-s130, Plymouth, MN 55441 Phone: 800-896-8936 Fax: 888-866-3209 |