Individual
TADELE BENTI DINSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5012932
NC
363L00000X
Nurse Practitioner
Primary
9148
MN
363LF0000X
Family Nurse Practitioner
RN216596
GA
Other
Enumeration date
06/24/2016
Last updated
05/02/2022
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