Individual
MRS. JETTIE MAE NDUMBE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3100 KENNARD ST STE 100, MAPLEWOOD, MN 55109-5466
(651) 225-5400
(612) 713-6727
Mailing address
3100 KENNARD ST STE 100, MAPLEWOOD, MN 55109-5466
(651) 225-5420
(612) 713-6727
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L423098
MN
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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