Carly Ann Lauer, CNP
Individual provider Active NPI Nurse Practitioner · Viking, MN
NPI 1164316873 · NPPES record last updated Jun 6, 2025
Key facts
- NPI
- 1164316873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 12891 (MN)
- Practice address
- 23313 145TH Ave NW
Viking, MN 56760-9522 - Phone
- (218) 201-2253
- NPI assigned
- Jun 6, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 12891 | MN | Yes |
Addresses
Primary practice location
23313 145TH Ave NW
Viking, MN 56760-9522
Mailing address
23313 145TH Ave NW
Viking, MN 56760-9522
Phone (218) 201-2253
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.