Individual
MS. LAURA JOYCE-CARLSON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6500 EXCELSIOR BLVD, PARK NICOLLET HEART AND VASCULAR CENTER, ST LOUIS PARK, MN 55426-4702
(952) 993-2304
(952) 993-3010
Mailing address
6500 EXCELSIOR BLVD, PARK NICOLLET HEART AND VASCULAR CENTER, ST LOUIS PARK, MN 55426-4702
(952) 993-2304
(952) 993-3010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9898
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463918900
—
MN
Enumeration date
12/30/2005
Last updated
07/20/2012
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