Individual
NUKUNU BOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
835 COUNTY ROAD B W, ROSEVILLE, MN 55113-4531
(612) 708-0910
Mailing address
5775 WAYZATA BLVD, SUITE 700, ST LOUIS PARK, MN 55416-1222
(612) 799-6508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R1827431
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348032
CLASS A PROFESSIONAL HOME HEALTH CARE AGENCY
MN
Enumeration date
09/13/2010
Last updated
09/13/2010
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