Provider Demographics
NPI:1982692232
Name:LAURING, CATHERINE ANN (RN, CNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:LAURING
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 HILLSVIEW W
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2172
Mailing Address - Country:US
Mailing Address - Phone:651-481-1136
Mailing Address - Fax:
Practice Address - Street 1:4570 W 77TH ST STE 350
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5035
Practice Address - Country:US
Practice Address - Phone:952-345-8770
Practice Address - Fax:952-345-8771
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP2385363LG0600X
MN2385363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN709714000Medicaid
MN500002371Medicare ID - Type Unspecified
MN709714000Medicaid