Healthcare Provider Details

I. General information

NPI: 1003548496
Provider Name (Legal Business Name): LAURA WRIGHTWOOD APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA WOODWICK RN, NP

II. Dates (important events)

Enumeration Date: 06/26/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SMITH AVE N STE 200
SAINT PAUL MN
55102-2697
US

IV. Provider business mailing address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2900
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-5111
  • Fax: 651-241-5512
Mailing address:
  • Phone: 763-520-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number8773
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: