Healthcare Provider Details

I. General information

NPI: 1417873183
Provider Name (Legal Business Name): LAURIE THOR DNP, APNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 N WATER ST STE 600
MILWAUKEE WI
53202-5715
US

IV. Provider business mailing address

270 MAIN ST N STE 300
STILLWATER MN
55082-6788
US

V. Phone/Fax

Practice location:
  • Phone: 877-599-1039
  • Fax:
Mailing address:
  • Phone: 651-342-1039
  • Fax: 651-342-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18378-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: