LAURA EVAVOLD BRODER (NPI# 1881858363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881858363 |
| Entity Type | Individual |
| Full Name | LAURA EVAVOLD BRODER |
| Other Name | LAURA CORINNE EVAVOLD |
| Credential | M.D. |
| Practice Address |
1885 Plaza Dr Eagan MN 55122-2979 |
| Mailing Address |
8170 33rd Ave S Po Box 1309 Mail Stop 21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 9529934001 |
| Practice Fax Number | 9529934095 |
| Mailing Telephone | 9529934001 |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2016-03-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 52647 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
1885 PLAZA DR |
| City | EAGAN |
| State | MN |
| Zip Code | 55122-2979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265416572 | Suzanne F Permuth | Family Medicine | 1885 Plaza Dr, Park Nicollet Clinic Eagan, Eagan, MN 55122-2612 | 2005-11-30 |
| 1124564240 | Nicholas Peter Wanner | Physician Assistant | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2017-01-12 |
| 1013271378 | Jeffrey John Mohr | Physician Assistant | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2012-07-01 |
| 1871866095 | Neha Sharma | Family Medicine | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2012-02-18 |
| 1043443500 | Clare Louise Macdonald-sexton | Social Worker | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2009-09-01 |
| 1730369539 | Rebecca Bell Benson | Physician Assistant | 1885 Plaza Dr, Eagan, MN 55122-2612 | 2007-11-08 |
| 1912121237 | Michele Christine Erickson | Family Medicine | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2007-04-11 |
| 1699807420 | Shivani Rawal | Family Medicine | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2007-03-09 |
| 1659450963 | Park Nicollet Health Care Products | Pharmacy | 1885 Plaza Dr, Eagan, MN 55122-2612 | 2006-11-06 |
| 1902900376 | Courtney J Smith | Physician Assistant | 1885 Plaza Dr, Eagan, MN 55122-2979 | 2006-09-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699035055 | Emily Catherwood Moody | Internal Medicine | 3305 Central Park Village Dr Ste 140, Eagan, MN 55121-7707 | 2012-05-19 |
| 1316185358 | Anne Marie Pylkas | Internal Medicine | 1440 Duckwood Dr # 100, Eagan, MN 55122-1451 | 2009-01-29 |
| 1376501130 | Karl R Parens | Internal Medicine | 1440 Duckwood Dr, Eagan, MN 55122-1451 | 2006-05-02 |
| 1407837446 | David A Yehl | Internal Medicine | 3305 Central Park Village Dr Ste 200, Eagan, MN 55121-7707 | 2005-11-08 |
| 1508336835 | Melissa Kizilos | Internal Medicine | 3535 Blue Cross Rd, Eagan, MN 55122-1154 | 2018-11-29 |
| 1003246182 | Paul Anthony Karazija | Internal Medicine | 3400 Yankee Dr, R416, Eagan, MN 55121-1627 | 2013-11-26 |
| 1326307786 | Evan Kendahl Moser-bleil | Internal Medicine | 3305 Central Park Village Dr, Eagan, MN 55121-7707 | 2012-05-04 |
| 1831456805 | Loann Mai Heuring | Internal Medicine | 3305 Central Park Village Dr Ste 200, Eagan, MN 55121-7707 | 2012-04-16 |
| 1699069930 | Donovan D Williams | Internal Medicine | 3305 Central Park Village Dr Ste 200, Eagan, MN 55121-7707 | 2011-06-03 |
| 1184916280 | Sarah Mcintire | Internal Medicine | 1440 Duckwood Dr, Eagan, MN 55122-1451 | 2011-05-07 |
| Find all providers in EAGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.