Healthcare Provider Details

I. General information

NPI: 1639450687
Provider Name (Legal Business Name): LAURA MARIE DELINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2011
Last Update Date: 09/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 EXCELSIOR BLVD
ST LOUIS PARK MN
55426-4702
US

IV. Provider business mailing address

15610 24TH AVE N UNIT E
PLYMOUTH MN
55447-6486
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-9000
  • Fax:
Mailing address:
  • Phone: 320-282-3384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number169766-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: