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1902579626
BRENDA SIMASIKU RUSS
BURNSVILLE, MN
NPI
1902579626
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MN 8307)
Enumeration Date
2021-07-28
Last Update Date
2021-09-24
Business Address
BRENDA SIMASIKU RUSS
2105 W 143RD ST # 2ND
BURNSVILLE, MN 55306-8000
Phone number: 952-303-6832
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Mailing Address
BRENDA SIMASIKU RUSS
10200 HIDDEN OAKS LN N
CHAMPLIN, MN 55316-3043
Phone number: 612-432-6964
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