Olitha Jamesetta Fofana AGPCNP-BC

NPI 1013301407 - Nurse Practitioner - 363LG0600X

NPI Details
NPI 1013301407
Gender Female
Enumeration Date 03/24/2015
Last Updated 03/24/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
10911 RHODE ISLAND CIR N
CHAMPLIN MN, 55316-3256, US
Phone (763) 493-2947
Fax
Business Location
10911 RHODE ISLAND CIR N
CHAMPLIN MN, 55316-3256, US
Phone (763) 493-2947
Fax
Toxanomy
Taxonomy Code 363LG0600X
License State Minnesota
License Number CNP 3783
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According to our database, Mrs. Olitha Jamesetta Fofana AGPCNP-BC NPI is 1013301407, taxonomy code is 363LG0600X and license number is CNP 3783, license state is located at Minnesota. Olitha Jamesetta Fofana AGPCNP-BC physically located at 10911 Rhode Island Cir N, Champlin MN, 55316-3256. NPI Number Olitha Jamesetta Fofana AGPCNP-BC has the Individual type.

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1013301407 NPI number is provided on an as is basis without warranty of any kind. 1013301407 is maintained by the National Plan & Provider Enumeration System. The contents of Olitha Jamesetta Fofana AGPCNP-BC are for informational purposes only.