Basic Information
| Provider Information | |||||||||
| NPI: | 1508345398 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUFF | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21140 GOLDENROD ST NW | ||||||||
| Address2: | |||||||||
| City: | OAK GROVE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550114740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126950931 | ||||||||
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| Practice Location | |||||||||
| Address1: | 480 OSBORNE RD NE STE AND200 | ||||||||
| Address2: | |||||||||
| City: | FRIDLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554322773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632363800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2018 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 6137 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.