Healthcare Provider Details

I. General information

NPI: 1780038596
Provider Name (Legal Business Name): SAUNDRA LAUER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MAIN ST W
MELROSE MN
56352-1043
US

IV. Provider business mailing address

1906 PARKVIEW RD NE
ALEXANDRIA MN
56308-8679
US

V. Phone/Fax

Practice location:
  • Phone: 320-256-4228
  • Fax:
Mailing address:
  • Phone: 320-766-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201634-8
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201634-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: