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Individual

DR. LAURAL MOKONCHU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
12826 GLEN CT, APPLE VALLEY, MN 55124-9490
(612) 990-7558
Mailing address
12826 GLEN CT, APPLE VALLEY, MN 55124-9490
(612) 990-7558

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9655
MN
363LP2300X
Primary Care Nurse Practitioner
9655
MN

Other

Enumeration date
06/03/2024
Last updated
06/03/2024
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