Provider Demographics
NPI:1134278021
Name:SCHNIEPP, LISA J (ATC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:J
Last Name:SCHNIEPP
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9025 BLOOMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2307
Mailing Address - Country:US
Mailing Address - Phone:651-324-6520
Mailing Address - Fax:
Practice Address - Street 1:9025 BLOOMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2307
Practice Address - Country:US
Practice Address - Phone:651-324-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE208OtherATHLETIC TRAINER
MN2303OtherMINNESOTA BOARD OF MEDICAL PRACTICE