Individual
MAHILET SISAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416-1670
(952) 345-3213
Mailing address
1375 DAVERN ST APT 408, SAINT PAUL, MN 55116-2290
(651) 925-9735
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
R 203829-0
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
10934
MN
Other
Enumeration date
11/08/2013
Last updated
02/08/2024
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