| NPI | 1144097999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE GEDDES Nurse Practitioner/Owner 651-334-4631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2025-01-17 |