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Individual

MIOSHI CRYSTAL CARTER BAUSAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3555 FRANCE AVE N, ROBBINSDALE, MN 55422-2488
(612) 236-9512
(763) 521-4166
Mailing address
5126 CHICAGO AVE, MINNEAPOLIS, MN 55417-1730
(612) 900-9369

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MN

Other

Enumeration date
04/02/2026
Last updated
04/02/2026
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