DIVINA FAMA BIKERI

ANDOVER, MN
NPI1003368929
Former NameDIVINA BIKERI MANYANGE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MN  CNP 4854)
Enumeration Date2016-10-26
Last Update Date2017-05-10
Business Address
-- DIVINA FAMA BIKERI CNP
15245 BLUEBIRD ST NW
ANDOVER, MN 55304-3538
Phone number: 763-587-4688
Mailing Address
-- DIVINA FAMA BIKERI CNP
8170 33RD AVE S MS 21110Q
MINNEAPOLIS, MN 55425-4516
Phone number: