Individual
DARRICK ADAM IDSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, AGPCNP-BC
Contact information
Practice address
225 SMITH AVE N STE 400, SAINT PAUL, MN 55102-2568
(651) 290-0133
(651) 241-2758
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11818
MN
363LG0600X
Gerontology Nurse Practitioner
11818
MN
Other
Enumeration date
07/16/2024
Last updated
11/04/2024
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