Individual
PASCALINE MAMBO NDIFOR SUHFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3800 PARK NICOLLET BLVD, SAINT LOUIS PARK, MN 55416-2527
(952) 993-3123
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10599
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1809161
NURSING
MN
Enumeration date
09/11/2020
Last updated
06/11/2026
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