Individual
DESIREAH GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 WASHINGTON AVE S, MINNEAPOLIS, MN 55401-2110
(210) 412-9591
Mailing address
100 WASHINGTON AVE S, MINNEAPOLIS, MN 55401-2110
(210) 412-9591
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
827913
TX
Other
Enumeration date
04/07/2021
Last updated
08/27/2021
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