Individual
MRS. GRACE JEPCHIRCHIR FIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6222 HEDGECROFT AVE S, COTTAGE GROVE, MN 55016-6002
(612) 859-8250
(651) 330-5351
Mailing address
6222 HEDGECROFT AVE S, COTTAGE GROVE, MN 55016-6002
(612) 859-8250
(651) 330-5351
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
2441890
MN
253J00000X
Foster Care Agency
Primary
1099897
MN
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/22/2019
Last updated
04/12/2022
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