Individual
LENA A IDRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7524 W 101ST ST, BLOOMINGTON, MN 55438-2109
(612) 703-9474
Mailing address
7524 W 101ST ST, BLOOMINGTON, MN 55438-2109
(612) 703-9474
Taxonomy
Speciality
Code
Description
License number
State
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
4205
MN
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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