Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 63790 | MN |
N | 207N00000X | Dermatologist | 65906 | WI |
NPI | 1013324227 |
---|---|
Provider Name | Dr. Lauren Brin Hermans |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55130-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2014 |
Last Update Date | 23/04/2021 |