Lacy M Doppler, RN

Individual provider Active NPI Registered Nurse · Fairmont, MN

NPI 1326487331 · NPPES record last updated Jun 24, 2013

Key facts

NPI
1326487331
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
201169-9 (MN)
Practice address
2490 Albion Ave
Fairmont, MN 56031-3301
Phone
(952) 412-0173
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201169-9MNMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201169-9 MN Yes

Addresses

Primary practice location

2490 Albion Ave
Fairmont, MN 56031-3301

Mailing address

2490 Albion Ave
Fairmont, MN 56031-3301

Other providers in Fairmont, MN

All providers in Fairmont, MN · Registered Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.