LYDIAH OTACHI

MAPLEWOOD, MN
NPI1689428070
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: MN  11498)
Additional Taxonomies363LG0600X Nurse Practitioner, Gerontology
(Licence: MN  11498)
363LA2200X Nurse Practitioner, Adult Health
(Licence: MN  11498)
Enumeration Date2024-04-12
Last Update Date2026-05-19
Business Address
LYDIAH OTACHI Nurse Practitioner
1900 SHERREN AVE E
MAPLEWOOD, MN 55109-2803
Phone number: 651-770-1365
Mailing Address
LYDIAH OTACHI Nurse Practitioner
PO BOX 1109
CROWN POINT, IN 46308-1109
Phone number: