Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | R1203880 | MN |
NPI | 1063482941 |
---|---|
Provider Name | Lisa Bratsch-Montag |
First Address | Kasota, MN 56050-9614 |
Second Address | Mankato, MN 56001-5287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 22/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07-00864 | MEDICA (01) | |
1022664 | PREFERRED ONE (01) | |
1067918 | AMERICA'S PPO (ARAZ) (01) | |
124880 | UCARE (01) | |
240596200 | (05) | MN |
28381 | SIOUX VALLEY HEALTH PLAN (01) | |
68G15CL | BCBS MN (01) | MN |
HP26547 | HEALTH PARTNERS (01) | |
P56783 | (02) |