Individual
ISHMAEL KOMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5317 BROOKDALE DR N, BROOKLYN PARK, MN 55443-3010
(763) 458-2727
(763) 207-0076
Mailing address
5317 BROOKDALE DR N, BROOKLYN PARK, MN 55443-3010
(763) 458-2727
(763) 207-0076
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R177789-5
MN
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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