Lisa Widder

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

1252967 Issued in MN

Practice address

9550 Upland LN N Ste 230
Maple Grove, MN 55369-4484

Phone

(952) 920-2730

NPI assigned

Jul 10, 2026

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

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

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1790604247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 118TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 UPLAND LN N STE 230",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694484",
            "telephone_number": "952-920-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDER",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "1252967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lana R White-King, M.D.
• Lisa R White, MA OTR/L
• Daniel Lee Whited, O.D.
• Ryan Wicht, D.C.
• Brittany Wiczek, MA, LMFT
• James Wiencke, MA, LPCC
• Jill Katherine Wieser, MD
• Sarah Elisabeth Wiger, PA
• Jeannette Louise Wilcox, MD
• Leslie Lorraine Wilcox, D.D.S.

• All providers in Maple Grove, MN
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.