Provider Demographics
NPI:1366412975
Name:OROZCO, LISA A (WHCNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:OROZCO
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3516 JERSEY AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2265
Mailing Address - Country:US
Mailing Address - Phone:612-874-9875
Mailing Address - Fax:
Practice Address - Street 1:1921 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1904
Practice Address - Country:US
Practice Address - Phone:612-874-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR134606-4363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN14F51SCOtherBCBS MN
MN203617700Medicaid
HP30025OtherHEALTH PARTNERS
1864681OtherAMERICA'S PPO (ARAZ)
1022332OtherPREFERRED ONE
128816OtherUCARE
07-03128OtherMEDICA
P76547Medicare UPIN
128816OtherUCARE