Organization
LIFESPARK MEDICAL GROUP, PA
Active
Other names
Lifesprk Health
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE ANN LAURING APRN, CNP (CEO)
(952) 345-3213
Entity
Organization
Contact information
Practice address
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416-1670
(952) 345-8770
(952) 345-8871
Mailing address
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416-1670
(952) 345-3213
(952) 345-8871
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
2385
MN
Other
Enumeration date
03/13/2018
Last updated
05/02/2022
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