Healthcare Provider Details
I. General information
NPI: 1497251615
Provider Name (Legal Business Name): LAUREN KLEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2018
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5625 CENEX DR
INVER GROVE HEIGHTS MN
55077-1724
US
IV. Provider business mailing address
8170 33RD AVE S # MS 21110Q
BLOOMINGTON MN
55425-4516
US
V. Phone/Fax
- Phone: 651-552-2600
- Fax: 651-552-2672
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 67293 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: