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1013735109
TRACY EBOSHOGUE ITSOSIME EKHATOR
BROOKLYN CENTER, MN
NPI
1013735109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: MN 2521094)
Enumeration Date
2024-09-28
Last Update Date
2024-09-28
Business Address
TRACY EBOSHOGUE ITSOSIME EKHATOR
5701 SHINGLE CREEK PKWY
BROOKLYN CENTER, MN 55430-2467
Phone number: 763-453-8752
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Mailing Address
TRACY EBOSHOGUE ITSOSIME EKHATOR
1543 159TH AVE NW
ANDOVER, MN 55304-4563
Phone number: 763-913-2216
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