Spark Medical Providers PA
NPI #1760374680 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1760374680
- Entity Type
- Organization
- Organization Name
- Spark Medical Providers PA
- Primary Specialty
- Internal Medicine - Geriatric Medicine
- Enumeration Date
- Jul 16, 2025
- Last Updated
- Jul 16, 2025
Practice Location
- Address
- 5320 W 23RD ST STE 130
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55416-1670
- Phone
- (952) 345-8770
Authorized Official
- Name
- CATHERINE ANN LAURING, NURSE PRACTITIONER
- Title
- CEO
- Phone
- (952) 345-8770
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Geriatric Medicine — Geriatric Medicine |
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