Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 8623 | MN |
NPI | 1013487552 |
---|---|
Provider Name | Ambe Ernest Che |
First Address | Brooklyn Park, MN 55443-1930 |
Second Address | Brooklyn Park, MN 55443-1930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2018 |
Last Update Date | 08/10/2021 |