Individual
ONORINE AMI SOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4763 SUNFLOWER DR, WOODBURY, MN 55129-1402
(952) 486-0124
Mailing address
4763 SUNFLOWER DR, WOODBURY, MN 55129-1402
(952) 486-0124
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2021210065
MN
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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