Organization
NEW DAWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHOEBE KERUBO NYABANDO NP (OWNER)
(612) 940-5651
Entity
Organization
Contact information
Practice address
904 PRINCETON AVE, SHAKOPEE, MN 55379-4534
(612) 940-5651
Mailing address
904 PRINCETON AVE, SHAKOPEE, MN 55379-4534
(612) 940-5651
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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