Individual
ETYANE AYANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17305 CEDAR AVE S STE 220, LAKEVILLE, MN 55044-3903
(952) 465-1959
(952) 236-0138
Mailing address
20787 GEMINI TRL, LAKEVILLE, MN 55044-2515
(952) 217-3635
(952) 236-0138
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R178274-1
MN
363LF0000X
Family Nurse Practitioner
Primary
F12220253
MN
Other
Enumeration date
06/30/2008
Last updated
01/17/2023
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