Provider Demographics
NPI:1134839533
Name:STRUTZ, LAURA A
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:STRUTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:DEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:ND
Mailing Address - Zip Code:58075-8510
Mailing Address - Country:US
Mailing Address - Phone:701-899-0369
Mailing Address - Fax:
Practice Address - Street 1:215 3RD ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:ND
Practice Address - Zip Code:58075-8510
Practice Address - Country:US
Practice Address - Phone:701-899-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant