Individual
DIAMOND EZELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 SOUTHCROSS DR W APT 2303, BURNSVILLE, MN 55306-7976
(651) 263-9543
Mailing address
1825 SOUTHCROSS DR W APT 2303, BURNSVILLE, MN 55306-7976
(651) 263-9543
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
391528
MN
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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