Deboer, Laresa G

Deboer, Laresa G is an individual health care provider with primary practice located at 500 S Maple St , Waconia MN 55387-1752. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Deboer, Laresa G can be contacted via phone (952) 442-2191.

Contact Information

Primary practice address
500 S Maple St Waconia MN 55387-1752
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 43130 Minnesota

Profile Details

NPI number 1316993231
LBN Legal business name Deboer, Laresa G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Dec 3rd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316993231 NPPES
Other 39-01795 MEDICA EMERG
Other HP32799 MEDICA EMERG
Other 1027863 MEDICA EMERG
Other 054M5DE MEDICA EMERG
Other 140370 MEDICA EMERG

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