Lisa Ann Fernelius, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R220414-7 Issued in MN

Practice address

3045 Ensign Ave N
New Hope, MN 55427-2424

Phone

(612) 423-4194

NPI assigned

Jul 7, 2014

Last updated

Jul 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1538575998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 ENSIGN AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554272424",
            "telephone_number": "612-423-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 ENSIGN AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554272424",
            "telephone_number": "612-423-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNELIUS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R220414-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairview Express Care (M Health Fairview Pediatric Therapy - New Hope)
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• Registered Nurse in New Hope, MN
• Providers in New Hope, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.