LAURIE A. FONG APRNCNP NPI 1568419612

NPI Information

NPI: 1568419612
Provider Name: LAURIE A. FONG, APRN,CNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501
Phone: (218) 847-5611
Get Directions

Laurie A. Fong, APRN,CNP is a psychiatric/mental health nurse practitioner in Detroit Lakes, MN. Laurie A. Fong, APRN,CNP NPI is 1568419612. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501-409
Phone: (218) 847-5611
Fax: (218) 847-0881

The enumeration date for this NPI number is 5/27/2006 and was last updated on 12/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SP0809X	Clinical Nurse Specialist	Psychiatric/Mental Health, Adult	R-073941-0	MINNESOTA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	R-073941-0	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1015289	OTHER	MINNESOTA	PREFERREDONE
2	444M0FO	OTHER	MINNESOTA	BLUE SHIELD OF MN
3	109897	OTHER	MINNESOTA	UCARE MINNESOTA
4	908239500	MEDICAID	MINNESOTA
5	H400117062	MEDICARE PIN	MINNESOTA
6	62-51179	OTHER	MINNESOTA	UNITED BEHAVIORAL HEALTH
7	71289	MEDICAID	NORTH DAKOTA
8	HP19196	OTHER	MINNESOTA	HEALTHPARTNERS
9	1568419612	MEDICAID	MINNESOTA
10	S55434	MEDICARE UPIN	MINNESOTA
11	N719254	MEDICARE PIN	NORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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