Individual
MR. EDWIN MOENGA BARAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11032 SWALLOW ST NW, COON RAPIDS, MN 55433-4164
(612) 730-7706
Mailing address
11032 SWALLOW ST NW, COON RAPIDS, MN 55433-4164
(612) 730-7706
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
1801761
MN
Other
Enumeration date
02/15/2020
Last updated
02/15/2020
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