Individual
YANQUA SUMOWUO PEWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4801 VETERAN DRIVE, SAINT CLOUD, MN 56303
(320) 252-6380
Mailing address
11109 34TH ST NE, SAINT MICHAEL, MN 55376-8457
(612) 270-4171
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
709356
MN
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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