| Lifespark Medical Group, Pa | |
|
5320 W 23rd St Ste 130 St Louis Park MN 55416-1670 | |
| (952) 345-3310 | |
| (952) 345-8771 |
| Full Name | Lifespark Medical Group, Pa |
|---|---|
| Speciality | Nurse Practitioner - Adult Health |
| Location | 5320 W 23rd St Ste 130, St Louis Park, Minnesota |
| Authorized Official Name and Position | Catherine Ann Lauring (VICE PRESIDENT) |
| Authorized Official Contact | 9523453213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespark Medical Group, Pa 5320 W 23rd St Ste 130 St Louis Park MN 55416-1670 Ph: (523) 453-3109 | Lifespark Medical Group, Pa 5320 W 23rd St Ste 130 St Louis Park MN 55416-1670 Ph: (952) 345-3310 |
| NPI Number | 1437930278 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 10/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437930278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Primary |
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