Individual
GRACE ADIYIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, MA
Contact information
Practice address
17430 49TH AVE N, PLYMOUTH, MN 55446-1713
(763) 222-8250
Mailing address
17430 49TH AVE N, PLYMOUTH, MN 55446-1713
(763) 222-8250
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
R163920-5
MN
163WC1500X
Community Health Registered Nurse
16662
MN
Other
Enumeration date
02/08/2013
Last updated
02/08/2013
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