Individual
ZAKO MOHAMED IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 855-8570
Mailing address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 855-8570
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
1961290
MN
363L00000X
Nurse Practitioner
8226
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8226
MN
Other
Enumeration date
05/24/2021
Last updated
06/15/2021
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