| Doctor Name: | LAURIE J PUNG |
| NPI Number: | 1528049970 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP CWHNP |
| License Number: | R1070602 |
| Business Practice Address: | 16830 198th Ave Nw Big Lake Clinic Big Lake, MN - 55309 |
| Business Phone Number: | 7632637300 |
| Business Fax Number: | |
| Mailing Address: | 1200 Sixth Ave N, Big Lake Clinic C/o Centracare Clinic ST CLOUD |
| State: | MN |
| Postal Code: | 56303 |
| Phone Number: | 7632637300 |
| Fax Number: | |
| NPI Enumeration Date: | 11/10/2005 |
| NPI Last Update Date: | 12/28/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | R1070602 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |