Individual
BAO VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12630 ABLE CIR NE, BLAINE, MN 55434-3180
(952) 381-1474
Mailing address
12630 ABLE CIR NE, BLAINE, MN 55434-3180
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
2456186
MN
Other
Enumeration date
01/26/2020
Last updated
01/26/2020
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