| NPI | 1437930278 |
|---|---|
| Doing Business As | LIFESPARK MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | CATHERINE ANN LAURING Vice President 952-345-3213 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2023-10-09 |