Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35223 | MN |
N | 207SG0201X | Clinical Genetics (M.D.) | ME142762 | FL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35223 | MN |
N | 208000000X | Pediatrician | 35223 | MN |
NPI | 1568544070 |
---|---|
Provider Name | Lisa Ann Schimmenti |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G02997 | (02) |