| NPI | 1245950062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONYELLE SHARMANE MILLER Psychiatric Nurse Practitioner 612-272-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-09-05 |