Provider Demographics
NPI:1194763284
Name:JURAN, LISA M (PHARM D)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:JURAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 WILLIAM AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2127
Mailing Address - Country:US
Mailing Address - Phone:952-922-9277
Mailing Address - Fax:
Practice Address - Street 1:7171 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4306
Practice Address - Country:US
Practice Address - Phone:952-277-8663
Practice Address - Fax:952-277-8664
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117528-0183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist