Provider Demographics
NPI:1699254490
Name:RUFF, LISA J (PA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:RUFF
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:800 E 28TH ST STE 401
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-0200
Practice Address - Fax:612-863-0235
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2022-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN12793363AS0400X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical