Provider Demographics
NPI:1518293216
Name:PHILBROOK, LAURA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:PHILBROOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:SEDRANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13100 WAYZATA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1821
Mailing Address - Country:US
Mailing Address - Phone:952-546-0616
Mailing Address - Fax:952-593-1778
Practice Address - Street 1:13100 WAYZATA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1821
Practice Address - Country:US
Practice Address - Phone:952-546-0616
Practice Address - Fax:952-593-1778
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR813006163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology