Individual
MRS. RAQUEL ALEJANDRA DE LA MATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
420 DELAWARE ST SE, MMC 195, MINNEAPOLIS, MN 55455-0341
(612) 624-5915
Mailing address
420 DELAWARE ST SE, MMC 195, MINNEAPOLIS, MN 55455-0341
(651) 269-3246
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R1942536
MN
363LG0600X
Gerontology Nurse Practitioner
R1942536
MN
390200000X
Student in an Organized Health Care Education/Training Program
R1942536
MN
Other
Enumeration date
07/09/2012
Last updated
08/09/2012
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