Individual
THERESA E. VONGSOUVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 DODD RD STE 250, EAGAN, MN 55121-2123
(612) 725-2000
Mailing address
2805 DODD RD STE 250, EAGAN, MN 55121-2123
(612) 725-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1801606
MN
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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