Provider Demographics
NPI:1679505770
Name:RINGUETTE, LAURA RUTH (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RUTH
Last Name:RINGUETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RUTH
Other - Last Name:LUCKOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17705 HUTCHINS DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345
Mailing Address - Country:US
Mailing Address - Phone:952-401-8300
Mailing Address - Fax:952-401-8373
Practice Address - Street 1:17705 HUTCHINS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4145
Practice Address - Country:US
Practice Address - Phone:952-401-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42964208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH21759Medicare UPIN