Individual provider Active NPI

Lisa Ann Horner, APRN CNP

  • Family Nurse Practitioner
  • Andover, MN
National Provider Identifier
1740792761
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP5408 Issued in MN
Practice address
3633 Bunker Lake Blvd NE
Andover, MN 55403-9998
Phone
(763) 421-5011
Fax
(763) 421-5011
NPI assigned
Oct 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP5408 MN Primary

Addresses

Primary practice location

3633 Bunker Lake Blvd NE
Andover, MN 55403-9998

Mailing address

1555 Northway Drive #110
Centracare Complex Care Clinic
St Cloud, MN 56303
Phone (320) 255-7195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171207002412 MN Practitioner - Nurse Practitioner 9537426051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5408MNMDClinical Child & Adolescent Psychologist
CNP5408MNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1740792761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DRIVE #110",
            "address_2": "CENTRACARE COMPLEX CARE CLINIC",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-255-7195",
            "fax_number": "320-200-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 BUNKER LAKE BLVD NE",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "554039998",
            "telephone_number": "763-421-5011",
            "fax_number": "763-421-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNER",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "APRN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP5408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.