Provider Demographics
NPI:1972582971
Name:MEYER, LAURA E (RN NP BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN NP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8674
Mailing Address - Street 2:1230 E MAIN ST MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC AT MAIN STREET
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8674
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 147588 3363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP41022OtherHEALTH PARTNERS
MN0117134OtherMEDICA
MN131296OtherUCARE
410849339 56001 C210OtherCHAMPUS
MN2409707OtherAMERICAS PPO
MN801S9MBOtherBCBS
P00106209OtherRR MEDICARE
MN438024000Medicaid
MNNA2951040635OtherPREFERRED ONE
MN0117134OtherMEDICA
MN500002583Medicare PIN