Individual
LAUREN GLENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1791
(952) 442-2191
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
69846
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
MN
Other
Enumeration date
04/05/2018
Last updated
08/06/2021
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