Organization
SPARK MEDICAL PROVIDERS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE ANN LAURING NURSE PRACTITIONER (CEO)
(952) 345-8770
Entity
Organization
Contact information
Practice address
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416-1670
(952) 345-8770
Mailing address
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416-1670
(952) 345-8770
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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