Individual
MRS. GRACE OGHENEKARO OYEFESOBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8468 TAMARACK VILLAGE, CVS MINUTE CLINIC, WOODBURY, MN 55125
(651) 278-5633
Mailing address
9633 HALE AVE S, COTTAGE GROVE, MN 55016-3894
(651) 769-0114
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982927943
—
MN
Enumeration date
05/04/2016
Last updated
10/07/2016
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