Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12299 | ND |
N | 207V00000X | Obstetrician & Gynecologist | 48239 | MN |
NPI | 1003823907 |
---|---|
Provider Name | Laura K. Andreson |
First Address | Grand Forks, ND 58206-6002 |
Second Address | Grand Forks, ND 58206-6002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 29/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
555150100 | (05) | MN |