Individual
LAURA M GANDRUD PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
(651) 855-2310
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
48276
MN
2080P0205X
Pediatric Endocrinology Physician
Primary
48276
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483695200
—
MN
Enumeration date
03/22/2006
Last updated
05/05/2020
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