Provider Demographics
NPI:1710576681
Name:MUNSKI, LAURA BERNICE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BERNICE
Last Name:MUNSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-2920
Mailing Address - Country:US
Mailing Address - Phone:218-779-9567
Mailing Address - Fax:
Practice Address - Street 1:2111 4TH AVE N
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2920
Practice Address - Country:US
Practice Address - Phone:218-779-9567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant