Provider Demographics
NPI:1225016710
Name:KOTTEN, LAURA LYNN (PHARM D)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:KOTTEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:STICKLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2210 LARK LN NW
Mailing Address - Street 2:
Mailing Address - City:STEWARTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55976-1063
Mailing Address - Country:US
Mailing Address - Phone:507-533-8509
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116881-5183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist