Individual
MY LAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
555 CEDAR ST, SAINT PAUL, MN 55101-2209
(651) 266-1343
(651) 266-1384
Mailing address
555 CEDAR ST, SAINT PAUL, MN 55101-2209
(651) 266-1343
(651) 266-1384
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 50160-6
MN
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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