Individual
MARDIYA KASSIM JAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 WABASHA ST S, SAINT PAUL, MN 55107-1805
(952) 853-8800
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(952) 853-8800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1977213
MN
363LF0000X
Family Nurse Practitioner
5725
MN
Other
Enumeration date
02/07/2018
Last updated
02/11/2019
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