Provider Demographics
NPI:1558036475
Name:LAUSTED, MEGAN (DNP, APRN, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LAUSTED
Suffix:
Gender:F
Credentials:DNP, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3244
Mailing Address - Country:US
Mailing Address - Phone:715-556-5006
Mailing Address - Fax:
Practice Address - Street 1:555 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2209
Practice Address - Country:US
Practice Address - Phone:651-266-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8376363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health