| NPI | 1396234407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANNA ROXANNE PITTMAN Register Nurse 651-354-4228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 1714036) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |