Organization
ARISE FAMILY MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANA WILMOT-DESOUZA MD (FOUNDER)
(512) 773-4524
Entity
Organization
Contact information
Practice address
7447 EGAN DR STE 207, SAVAGE, MN 55378-3301
(763) 381-5607
Mailing address
15815 FRANKLIN TRL SE STE 501, PRIOR LAKE, MN 55372-2076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
03/14/2024
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