LISA R DAVIDSON (NPI# 1184603193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184603193 |
| Entity Type | Individual |
| Full Name | LISA R DAVIDSON |
| Credential | MD |
| Practice Address |
1230 E Main Street Mankato Clinic At Main Street Mankato MN 56002-8674 |
| Mailing Address |
Po Box 8674 1230 E Main St Mankato Clinic Ltd Mankato MN 56002-8674 |
| Practice Telephone | 5076251811 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
43496 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | 130024186 | 01 | |
| IA | MEDICAID | 0947127 | 01 |
| MN | HEALTH PARTNERS | HP32997 | 01 |
| MN | AMERICAS PPO | 1328361 | 01 |
| MN | BCBS | 45D61DA | 01 |
| MN | PREFERRED ONE | NA2951027572 | 01 |
| MN | 071645600 | 05 | |
| MN | MEDICA | 0500173 | 01 |
| MN | UCARE | 151694 | 01 |
| CHAMPUS | 410849339 56001 C181 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966343 | Lisa Davidson | Speech-Language Pathologist | 12933 Erie Pl, Fishers, IN 46037-7832 | 2020-09-09 |
| 1124416839 | Lisa Renee Davidson | Pharmacist | 517 Winchester Dr, West Plains, MO 65775-3936 | 2015-01-03 |
| 1659497600 | Lisa Anita Davidson | Psychologist | 14015 Midland Rd, Poway, CA 92064-3959 | 2007-03-21 |
| 1235185406 | Lisa Diane Davidson | Family Medicine | 2373 Central Park Blvd Unit 205, Denver, CO 80238-2300 | 2006-05-26 |
| 1932101300 | Lisa H Davidson | Audiologist | 904 N Chancery St, Mcminnville, TN 37110-1503 | 2005-08-15 |
| 1285026880 | Lisa Ann Davidson | Registered Nurse | 1800 Nw Myhre Rd, Silverdale, WA 98383-7663 | 2015-02-19 |
| 1740327998 | Lisa Davidson | Audiologist | 4560 Clayton Ave, Saint Louis, MO 63110-1502 | 2007-01-30 |
| 1477627461 | Lisa Elizabeth Davidson | Physical Therapist | 3751 S State Rd, Ionia, MI 48846 | 2006-11-20 |
| 1316900947 | Lisa Davidson | Internal Medicine | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2006-04-06 |
| 1568436939 | Lisa L Davidson | Nurse Practitioner | 4730 Chicago Ave, Minneapolis, MN 55407-3570 | 2006-02-14 |
| Street Address |
1230 E MAIN STREET MANKATO CLINIC AT MAIN STREET |
| City | MANKATO |
| State | MN |
| Zip Code | 56002-8674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457346926 | Scott J Barnacle | Obstetrics & Gynecology | 1230 E Main Street, Mankato, MN 56002-8674 | 2005-09-12 |
| 1124210398 | Tara Jean Denke | Obstetrics & Gynecology | 1230 E Main Street, Mankato Clinic At Main Street, Mankato, MN 56002-8674 | 2007-08-13 |
| 1174650816 | Karen M Hansen | Physician Assistant | 1230 E Main Street, Mankato Clinic At Main Street, Mankato, MN 56002-8674 | 2007-02-28 |
| 1093752412 | James A Boles | Internal Medicine | 1230 E Main Street, Mankato Clinic Main Street, Mankato, MN 56001 | 2006-06-02 |
| 1497734446 | James R Custer | Radiology | 1230 E Main Street, Mankato Clinic At Main Street, Mankato, MN 56002-8674 | 2006-01-10 |
| 1366421356 | Peter S Nolan | Pediatrics | 1230 E Main Street, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2006-01-10 |
| 1881673879 | Rolf E Storvick | Internal Medicine | 1230 E Main Street, Mankato Clinic, Mankato, MN 56002-8674 | 2006-01-10 |
| 1003895095 | Alyssa L Stitt | Family Medicine | 1230 E Main Street, Mankato Clinic, Mankato, MN 56002-8674 | 2006-01-10 |
| 1821077819 | Donald C Putzier | Pediatrics | 1230 E Main Street, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2006-01-10 |
| 1841279833 | Eric J Storvick | Internal Medicine | 1230 E Main Street, Mankato Clinic At Main Street, Mankato, MN 56002-8674 | 2006-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518004803 | Karl Philip Roos | Internal Medicine | 1230 East Main Street, Mankato, MN 56002 | 2007-01-30 |
| 1194766055 | Winny W Hung | Emergency Medicine | 1025 Marsh St, Dept. of Emergency Medicine, Mankato, MN 56002 | 2006-06-09 |
| 1316974967 | Dale L Carlson | Optometrist | 220 East Main, Mankato, MN 56002-3387 | 2006-06-27 |
| 1992789986 | Brenda Oian Iv | Marriage & Family Therapist | Blue Earth County Government Center, 410 South 5th Street, Mankato, MN 56002-3526 | 2005-12-02 |
| 1811040769 | County of Blue Earth | Public Health or Welfare | 410 S 5th St, Mankato, MN 56002-3526 | 2007-01-22 |
| 1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
| 1962660324 | Hope Rene Bollig | Physician Assistant | 1015 Marsh St, Mankato, MN 56002-8673 | 2008-06-01 |
| 1649324690 | Matthew James Schaefer | Radiology | 1025 Marsh St, Mankato, MN 56002-8673 | 2007-01-23 |
| 1427131895 | Matthew Gerald Pollema | Radiology | 1025 Marsh St, Mankato, MN 56002-8673 | 2006-10-21 |
| 1144217209 | Erin E Bissonnette | Nurse Practitioner | 1230 E. Main Street, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2005-10-04 |
| Find all providers in zip 56002 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325173 | Kimberly A Aho | Psychiatry & Neurology | 1230 E Main St, Mankato, MN 56001-5066 | 2005-06-08 |
| 1396164380 | Han Wang | Psychiatry & Neurology | 1025 Marsh St, Mankato, MN 56001-4752 | 2014-04-07 |
| 1548362114 | Nidal Alkurdy | Psychiatry & Neurology | 1230 E. Main Street, Mankato Clinic @ Maint Street, Mankato, MN 56002-8674 | 2006-09-02 |
| 1558345439 | Andrew L Reeves | Psychiatry & Neurology | 1015 Marsh St, Mankato, MN 56001-5294 | 2005-12-03 |
| 1164403994 | Thanh K Dang | Psychiatry & Neurology | 1230 E Main St, Mankato, MN 56001-5066 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905251 | Nexus | Psychiatry & Neurology | 2121 Campus Dr Se, Rochester, MN 55904-4744 | 2020-09-02 |
| 1669995528 | Malik Ghannam | Psychiatry & Neurology | 701 15th Ave Se, Minneapolis, MN 55414-4047 | 2017-07-24 |
| 1477903995 | James Albert Zeese Jr. | Psychiatry & Neurology | 2401 Laurel Avenue, Minneapolis, MN 55405 | 2016-06-15 |
| 1265790414 | Brian Michael Krasnow | Psychiatry & Neurology | 1746 Hillcrest Avenue, Saint Paul, MN 55116-2151 | 2012-04-25 |
| 1699079533 | Gilbert Westreich | Psychiatry & Neurology | 1779 Emerson Ave South, Minneapolis, MN 55403-2909 | 2011-01-07 |
| 1720233570 | West Central Neurology Pa | Psychiatry & Neurology | 11521 312th Ave, Princeton, MN 55371-3423 | 2008-11-20 |
| 1235388521 | Donald W Klass | Psychiatry & Neurology | 956 14th Ave Sw, Rochester, MN 55902-2078 | 2008-09-11 |
| 1598929267 | Frank Wilson Sharbrough IIi | Psychiatry & Neurology | 814 8th Ave Sw, Rochester, MN 55902-6308 | 2008-07-11 |
| 1881855187 | Kenneth James Shea IIi | Psychiatry & Neurology | 3540 17th Ave S, Saint Cloud, MN 56301-9664 | 2008-06-19 |
| 1275792293 | Ali Emami | Psychiatry & Neurology | 310 Smith Ave N Ste 440, Saint Paul, MN 55102-2316 | 2008-06-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LISA R DAVIDSON.
| 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.