Provider Demographics
NPI:1407734601
Name:SZUPER, LISA CHRISTINE (RRT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINE
Last Name:SZUPER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:CHRISTINE
Other - Last Name:URI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5284 ROLLING HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-7409
Mailing Address - Country:US
Mailing Address - Phone:734-674-1617
Mailing Address - Fax:
Practice Address - Street 1:1300 HIDDEN LAKES PKWY
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4286
Practice Address - Country:US
Practice Address - Phone:763-588-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5761227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered