Organization
SUMMIT ADVANCE MOBILE WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY MOMANYI NP (NURSE PRACTITIONER)
(612) 598-8555
Entity
Organization
Contact information
Practice address
6773 DEERWOOD LN N, MAPLE GROVE, MN 55369-5530
(612) 598-8555
Mailing address
6773 DEERWOOD LN N, MAPLE GROVE, MN 55369-5530
(612) 598-8555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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