Individual
MARA CHANDRA LILA MENDONZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-8383
Mailing address
6400 BARRIE RD APT 1310, EDINA, MN 55435-2319
(507) 261-3563
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10140
MN
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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