Doctor Name: | MIRIAM INGUTIA |
NPI Number: | 1164602363 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | R-146675-3 |
Business Practice Address: | 3301 7th Ave Anoka, MN - 553034516 |
Business Phone Number: | 6514315000 |
Business Fax Number: | |
Mailing Address: | 7109 79th Ave N, BROOKLYN PARK |
State: | MN |
Postal Code: | 554452655 |
Phone Number: | 7634245631 |
Fax Number: | |
NPI Enumeration Date: | 11/06/2007 |
NPI Last Update Date: | 11/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R-146675-3 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |