Provider Demographics
NPI:1326044850
Name:HOWE, LISA A (PA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:HOWE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 WILLIAM ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4350
Mailing Address - Country:US
Mailing Address - Phone:608-769-2542
Mailing Address - Fax:
Practice Address - Street 1:1110 WILLIAM ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-4350
Practice Address - Country:US
Practice Address - Phone:608-769-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8875363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41986900Medicaid
WI41986900Medicaid
WI41986900Medicaid