Individual
MRS. LAURA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
2355 HIGHWAY 36 W, ROSEVILLE, MN 55113-3902
(763) 412-1993
Mailing address
2355 HIGHWAY 36 W STE 400, ROSEVILLE, MN 55113-3905
(763) 412-1993
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
363L00000X
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
1686
MN
Other
Enumeration date
08/24/2010
Last updated
11/12/2020
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