| Lyle David Willock, RNFA, PA, ROPA-C | |
|
775 Prairie Center Dr, Suite 250, Eden Prairie, MN 55344-7314 | |
| (952) 944-2519 | |
| (952) 944-0460 |
| Full Name | Lyle David Willock |
|---|---|
| Gender | Male |
| Speciality | Clinical Nurse Specialist |
| Location | 775 Prairie Center Dr, Eden Prairie, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972619690 | NPI | - | NPPES |
| 969991011727 | Other | PREFERREDONE | |
| 73B62WI | Other | BLUECROSS BLUESHIELD | |
| HP43945 | Other | HEALTHPARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 364S00000X | Clinical Nurse Specialist | R0773991 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Lyle David Willock, RNFA, PA, ROPA-C 6465 Wayzata Blvd, Suite 900, St Louis Park, MN 55426-1728 Ph: (952) 512-5600 | Lyle David Willock, RNFA, PA, ROPA-C 775 Prairie Center Dr, Suite 250, Eden Prairie, MN 55344-7314 Ph: (952) 944-2519 |
Ms. Mary Margaret Andersen, APRN, CNS, MSN Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 11800 Singletree Ln, Suite 204, Eden Prairie, MN 55344 Phone: 952-322-8532 | |
Laurie Jean Whitbeck, LPN, OPA-C Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 775 Prairie Center Dr, Suite 250, Eden Prairie, MN 55344 Phone: 952-944-2519 Fax: 952-944-0460 | |
Joan Marie Gibson, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 11800 Singletree Ln Ste 204, Eden Prairie, MN 55344 Phone: 612-440-6557 |