Mrs. Olitha Jamesetta Fofana
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health Nurse Practitioner - Primary Care
10911 Rhode Island Cir N
Champlin
, Minnesota 55316-3256
Mrs. Olitha Jamesetta Fofana
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health Nurse Practitioner - Primary Care
10911 Rhode Island Cir N
Champlin
, Minnesota 55316-3256
(763) 493-2947
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About
Features
Specialties
- Nurse Practitioner - Adult Health
- Nurse Practitioner - Gerontology
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Mrs. Olitha Jamesetta Fofana
- 10911 Rhode Island Cir N
- Champlin, MN
- Zip : 55316-3256
- Phone : (763) 493-2947
Second Address
- Mrs. Olitha Jamesetta Fofana
- 10911 Rhode Island Cir N
- Champlin, MN
- Zip : 55316-3256
- Phone : (763) 493-2947
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | CNP 3783 | MN |
| N | 363LG0600X | Nurse Practitioner - Gerontology | CNP 3783 | MN |
| N | 363LP2300X | Nurse Practitioner - Primary Care | CNP 3783 | MN |
National Provider Identifier
| NPI | 1013301407 |
|---|---|
| Provider Name | Mrs. Olitha Jamesetta Fofana |
| First Address | Champlin, MN 55316-3256 |
| Second Address | Champlin, MN 55316-3256 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/03/2015 |
| Last Update Date | 24/03/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.