Basic Information
Provider Information | |||||||||
NPI: | 1538269568 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LEHMANN | ||||||||
FirstName: | SHARON | ||||||||
MiddleName: | LUCILLE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | CNS | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 720 WASHINGTON AVENUE SE, SUITE 200 | ||||||||
Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
City: | MINNEAPOLIS | ||||||||
State: | MN | ||||||||
PostalCode: | 55414 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6128840649 | ||||||||
FaxNumber: | 6126768992 | ||||||||
Practice Location | |||||||||
Address1: | 500 HARVARD STREET SE | ||||||||
Address2: | UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW | ||||||||
City: | MINNEAPOLIS | ||||||||
State: | MN | ||||||||
PostalCode: | 554550363 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6122733000 | ||||||||
FaxNumber: | 6122738459 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/22/2006 | ||||||||
LastUpdateDate: | 09/05/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364S00000X | R 088533-5 | MN | N |   | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |   | 364SA2200X | R088533-5 | MN | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
ID Information
ID | Type | State | Issuer | Description | 140909 | 01 | MN | UCARE | OTHER | 04-06822 | 01 | MN | MEDICA PRIMARY | OTHER | 368617500 | 05 | MN |   | MEDICAID | 1497544 | 01 | MN | ARAZ | OTHER | 439869 | 01 | MN | FAIRVIEW | OTHER | 04-06821 | 01 | MN | MEDICA CHOICE | OTHER | HP40503 | 01 | MN | HEALTH PARTNERS | OTHER | 1029891 | 01 | MN | PREFERRED ONE | OTHER |