Gandrud Pickett, Laura M

Gandrud Pickett, Laura M is an individual health care provider with primary practice located at 3800 Park Nicollet Blvd , St Louis Park MN 55416-2527. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is her primary health care specialty. Gandrud Pickett, Laura M can be contacted via phone (952) 993-3123.

Contact Information

Primary practice address
3800 Park Nicollet Blvd St Louis Park MN 55416-2527
Phone: (952) 993-3123
Fax: (651) 855-2310
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 48276 Minnesota
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 48276 Minnesota

Profile Details

NPI number 1578522009
LBN Legal business name Gandrud Pickett, Laura M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated May 5th, 2020 - about 4 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 1578522009 NPPES
Minnesota MEDICAID 483695200

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