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Individual

EBYAN MOHAMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
3008 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3316
(612) 378-1040
(612) 378-2850
Mailing address
3008 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3316
(612) 378-1040
(612) 378-2850

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R244890-3
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
766822850
MN
Enumeration date
08/16/2017
Last updated
08/16/2017
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