Provider Demographics
NPI:1811952724
Name:CARROLL-CONTRERAS, LAURA CHRISTINA (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CHRISTINA
Last Name:CARROLL-CONTRERAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:CHRISTINA
Other - Last Name:CARROLL-CONTRERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4300 MARKET PTE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5435
Mailing Address - Country:US
Mailing Address - Phone:952-835-9880
Mailing Address - Fax:952-857-1554
Practice Address - Street 1:4050 COON RAPIDS BLVD
Practice Address - Street 2:MERCY MEDICAL CENTER
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-236-7144
Practice Address - Fax:763-236-7733
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43868207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
43868OtherMN MEDICAL LICENSE
MN203610000Medicaid