Healthcare Provider Details

I. General information

NPI: 1407703242
Provider Name (Legal Business Name): LAURA ELIZABETH KISER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ELTON HILLS LN NW
ROCHESTER MN
55901-3577
US

IV. Provider business mailing address

105 2ND ST SE
SEBEKA MN
56477-2775
US

V. Phone/Fax

Practice location:
  • Phone: 507-292-1006
  • Fax:
Mailing address:
  • Phone: 218-539-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15040
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: