Individual
LAUREN ELIZABETH GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
15650 CEDAR AVE, APPLE VALLEY, MN 55124
(952) 997-4100
Mailing address
15650 CEDAR AVE, APPLE VALLEY, MN 55124-7283
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005195
IL
363A00000X
Physician Assistant
Primary
11685
MN
Other
Enumeration date
09/19/2014
Last updated
07/19/2019
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