Individual
OSETOHAMEN ELIZABETH AGENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5727 BROOKLYN BLVD, MINNEAPOLIS, MN 55429-3057
(763) 202-6150
(763) 205-5878
Mailing address
5727 BROOKLYN BLVD, MINNEAPOLIS, MN 55429-3057
(763) 202-6150
(763) 205-5878
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2020045045
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2020045045
MN
Other
Enumeration date
11/12/2019
Last updated
05/14/2026
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