Organization
COMMUNITY NURSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERKALOAH AMANDA QUEEGLAY-TARPEH (REGISTERED NURSE)
(612) 387-6629
Entity
Organization
Contact information
Practice address
18072 VANCE CIRCLE, ELK RIVER, MN 55330
(612) 387-6629
(763) 267-7245
Mailing address
18072 VANCE CIR NW, ELK RIVER, MN 55330-4712
(612) 387-6629
(763) 267-7245
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
MN
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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