Individual
MAI NOU THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2196 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2708
(651) 702-0233
Mailing address
2196 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2708
(651) 704-0322
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R2107613
MN
163WH0200X
Home Health Registered Nurse
R2107613
MN
363LF0000X
Family Nurse Practitioner
Primary
9963
MN
363LP2300X
Primary Care Nurse Practitioner
9963
MN
Other
Enumeration date
04/08/2015
Last updated
02/21/2023
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