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TREASURE T TAKANG-ENOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(832) 497-7119
Mailing address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(832) 497-7119

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
833234
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11144
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146819
TX
Enumeration date
10/24/2014
Last updated
01/19/2024
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