Fong, Laurie A.
Fong, Laurie A. is an individual health care provider with primary practice located at 1027 Washington Ave , Detroit Lakes MN 56501-3409. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Fong, Laurie A. can be contacted via phone (218) 847-5611.Contact Information
Primary practice address
1027 Washington Ave
Detroit Lakes MN 56501-3409
Phone: (218) 847-5611
Fax: (218) 847-0881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult | 364SP0809X | R-073941-0 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | R-073941-0 | Minnesota |
Profile Details
| NPI number | 1568419612 |
|---|---|
| LBN Legal business name | Fong, Laurie A. |
| Credentials | APRN,CNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Dec 23rd, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568419612 | NPPES |
| Minnesota | Other | 109897 | UCARE MINNESOTA |
| Minnesota | Other | 1015289 | UCARE MINNESOTA |
| Minnesota | Other | 444M0FO | UCARE MINNESOTA |
| Minnesota | Other | 62-51179 | UCARE MINNESOTA |
| Minnesota | MEDICAID | 908239500 | UCARE MINNESOTA |
| Minnesota | MEDICAID | 71289 | UCARE MINNESOTA |
| Minnesota | Other | HP19196 | UCARE MINNESOTA |
| Minnesota | MEDICAID | 1568419612 | UCARE MINNESOTA |
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