Individual
LAURA LYNNE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-8375
(218) 546-4400
Mailing address
318 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-8375
(218) 546-4400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9404
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
579110300
—
MN
Enumeration date
12/05/2005
Last updated
12/01/2020
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