NPI 1972619690

Lyle David Willock, RNFAPAROPAC

Practitioner Clinical Nurse Specialist Eden Prairie, MN

Practice location

Address: 775 Prairie Center Dr Suite 250, Eden Prairie, MN 55344-7314
Phone: (952) 944-2519
Fax: (952) 944-0460
Mailing address: 6465 Wayzata Blvd Suite 900, St Louis Park, MN 55426-1728

Registered specialties

Clinical Nurse Specialist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 364S00000X Licence R0773991 (MN)

Other Clinical Nurse Specialist providers in Minnesota →

Registry record

NPI: 1972619690
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Aug 2006
Record last updated: 11 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.