Individual
TARIKUA KATISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
10792 ASHLEY LN, WOODBURY, MN 55129-6903
(651) 497-1459
Mailing address
10792 ASHLEY LN, WOODBURY, MN 55129-6903
(651) 497-1459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12379
MN
Other
Enumeration date
04/05/2025
Last updated
04/05/2025
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