Individual
FARDOSA FARAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2216 LIBERTY LN, EAGAN, MN 55122-1957
(320) 224-1733
Mailing address
2216 LIBERTY LN, EAGAN, MN 55122-1957
(320) 224-1733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2164669
MN
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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