Individual
SAMUEL NWANEKPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1821 UNIVERSITY AVE W STE S348, SAINT PAUL, MN 55104-2876
(651) 493-3834
(651) 493-3835
Mailing address
2623 GREY EAGLE DR, WOODBURY, MN 55129-4297
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11050
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R 154140-3
MINNESOTA BOARD OF NURSING
MN
Enumeration date
07/20/2016
Last updated
11/21/2023
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