Provider Demographics
NPI:1699056077
Name:CUEVA, LAURA L (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:CUEVA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30706 COUNTY 60
Mailing Address - Street 2:
Mailing Address - City:BROWERVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56438-4914
Mailing Address - Country:US
Mailing Address - Phone:701-361-4696
Mailing Address - Fax:
Practice Address - Street 1:1023 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3336
Practice Address - Country:US
Practice Address - Phone:320-632-1639
Practice Address - Fax:320-632-5160
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist