Individual
LAURA ELIZABETH WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1536 HEWITT AVE # MS -C1908, SAINT PAUL, MN 55104-1284
(651) 523-2204
Mailing address
1930 GRAND AVE, SAINT PAUL, MN 55105-1409
(612) 799-9797
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1437
MN
Other
Enumeration date
07/14/2010
Last updated
08/28/2020
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