Individual
PENINAH GESARE OMOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5712 BROOKDALE DR N, BROOKLYN PARK, MN 55443-3106
(763) 377-2069
Mailing address
10909 QUEBEC WAY N, CHAMPLIN, MN 55316-3262
(763) 377-2069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13898
MN
Other
Enumeration date
02/20/2026
Last updated
02/20/2026
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