Individual
LYDIAH KERUBO OMWOYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8642 149TH CT NW, RAMSEY, MN 55303-6643
(763) 898-7779
Mailing address
8642 149TH CT NW, RAMSEY, MN 55303-6643
(763) 898-7779
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2470205
MN
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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