Individual
RISPER KEMUNTO NYABOGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12404 ALDER ST NW, COON RAPIDS, MN 55448-4801
(952) 200-7691
Mailing address
12404 ALDER ST NW, COON RAPIDS, MN 55448-4801
(952) 200-7691
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-186631-1
MN
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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