Individual
LAURA CHRISTINE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
7701 YORK AVE S STE 189, ENDOCRINOLOGY CLINIC OF MINNEAPOLIS, EDINA, MN 55435-5238
(952) 915-4156
(952) 927-6309
Mailing address
7701 YORK AVE S STE 189, ENDOCRINOLOGY CLINIC OF MINNEAPOLIS, EDINA, MN 55435-5238
(952) 915-4156
(952) 927-6309
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3055
MN
133V00000X
Registered Dietitian
763
ND
133V00000X
Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000298908
BCBS PIN
MT
05
—
0280823
—
MT
Enumeration date
07/10/2006
Last updated
03/15/2013
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