Individual
JUDITH MORAA WANYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1801 NICOLLET AVE, MINNEAPOLIS, MN 55403-3791
(612) 823-2947
Mailing address
900 NICOLLET MALL, MINNEAPOLIS, MN 55403-2530
(763) 377-2069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
C4935
MN
363L00000X
Nurse Practitioner
Primary
CNP4935
MN
363LF0000X
Family Nurse Practitioner
APN.0992867-NP
CO
Other
Enumeration date
12/23/2016
Last updated
09/22/2021
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