Forest Lake Skin and Vein Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FOREST LAKE SKIN AND VEIN CLINIC

Practice address

280 12TH St SW
Suite a
Forest Lake, MN 55025-3778

Phone

(651) 464-7273

Fax

(651) 464-7969

NPI assigned

Dec 23, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lesa Renae Stegner, CNP

Title

President

Phone

(651) 464-7273

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer A Lake, MD

  • Family Medicine Physician
  • White Bear Lake, MN
  • NPI 1245205301
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229990400000",
    "number": "1013153907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 12TH ST SW",
            "address_2": "SUITE A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550253778",
            "telephone_number": "651-464-7273",
            "fax_number": "651-464-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 12TH ST SW",
            "address_2": "SUITE A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550253778",
            "telephone_number": "651-464-7273",
            "fax_number": "651-464-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LAKE SKIN AND VEIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A",
        "authorized_official_last_name": "STEGNER",
        "authorized_official_first_name": "LESA",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-464-7273",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Lake Chiropractic Clinic, P.a.
• Forest Lake Endodontics
• Forest Lake Home Care Inc
• Forest Lake Optometric Center (North Woods Optics)
• Forest Lake Orthodontics (Travis W. Wille, DDS, MS)
• Forest Lake Smiles, PA
• Lisa Marie Forslund, CNP
• Harvey J Frank, MD
• Alicen Fritzinger
• Sondra Decker Fruzzetti, M.S.W., LSCSW

• Primary Care Clinic/Center in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.