Individual
BERNICE MAMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10805 173RD ST W, LAKEVILLE, MN 55044-5335
(612) 247-0031
Mailing address
10805 173RD ST W APT 220, LAKEVILLE, MN 55044-5340
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2491111
MN
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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