| NPI | 1891686259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENARD KOSGEI CHESSUM Provider 612-406-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-14 |