Individual
CHARMIQUA AUDRELLE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
671 VANDALIA ST, SAINT PAUL, MN 55114-1312
(651) 698-2406
Mailing address
671 VANDALIA ST, SAINT PAUL, MN 55114-1312
(651) 698-2406
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6608
MN
Other
Enumeration date
11/11/2020
Last updated
04/28/2022
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