Provider Demographics
NPI:1003143926
Name:HERMANN, LAURA JEAN (MA, RN-BSN, CNS-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:HERMANN
Suffix:
Gender:F
Credentials:MA, RN-BSN, CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 CHURCHILL CT
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-5903
Mailing Address - Country:US
Mailing Address - Phone:651-484-9231
Mailing Address - Fax:
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2533
Practice Address - Country:US
Practice Address - Phone:651-726-6338
Practice Address - Fax:651-726-0366
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 162032-4364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health