Most Relevant Information
Provider Data
| NPI Number: | 1003461864 |
| Provider Name: | HARON NYAKUNDI MANWA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 6804 |
Most Important Dates
| Enumeration Date: | 08/07/2019 |
| Last Updated: | 08/07/2019 |
Provider Practice Location
3301 7TH AVE
ANOKA
MN
553034516
Practice Location Phone/Fax
| Phone: | 6514315000 |
| Fax: |
Provider Mailing Location
7223 114TH LN N
CHAMPLIN
MN
553162860
Provider Mailing Phone/Fax
| Phone: | 6125326404 |
| Fax: |