Individual
MIA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 672-7422
Mailing address
720 WASHINGTON AVE SE STE 300, MINNEAPOLIS, MN 55414-2904
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6983
MN
Other
Enumeration date
03/23/2017
Last updated
01/08/2020
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