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Individual

LAURIE MALM-GERHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1953 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3427
(651) 659-0208
(651) 659-0161
Mailing address
7246 TYLER RD, SIREN, WI 54872-9276

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R 136488-4
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106502
UCARE MN
MN
01
181585
UCARE MN PCA
MN
01
37865
HEALTH PARTNERS
MN
01
4J19CA
BCBS
MN
01
5900010
MEDICA
MN
Enumeration date
03/09/2007
Last updated
07/09/2007
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