Lisa Eleanor Fahey-Bleick, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R1205765 Issued in MN

Practice address

4178 Knob Dr
Suite a
Eagan, MN 55122-2888

Phone

(651) 209-8640

Fax

(651) 209-8690

NPI assigned

Jun 12, 2006

Last updated

Feb 10, 2009By 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)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagan Child and Family Care, P.a.

  • Pediatrics Physician
  • Eagan, MN
  • NPI 1629000682

  Family

  NPD (past)
• Regents of the University of Minnesota

  dba Community-University Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  NPD (past)
• Regents of the University of Minnesota

  dba Boynton Health Service

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1710929062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 COBBLER AVE",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550687130",
            "telephone_number": "651-423-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4178 KNOB DR",
            "address_2": "SUITE A",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222888",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY-BLEICK",
        "first_name": "LISA",
        "middle_name": "ELEANOR",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1205765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excelpath Behavioral Solutions Inc
• Express Housing LLC
• Lucero Ayelet Ezekiel
• Toyia Ezeokafor, BA
• Taryn Leigh Facella-Scheuer, APN
• Fairview Clinics (M Health Fairview Clinic - Eagan)
• Fairview Express Care
• Fairview Express Care
• Fairview Express Care (Fairview Rehabilitation Services - Eagan)
• Fairview Pharmacy Services LLC (Fairview Eagan Clinic MTM)

• Family Nurse Practitioner in Eagan, MN
• Providers in Eagan, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.