Most Relevant Information
Provider Data
| NPI Number: | 1003463746 |
| Provider Name: | DIAMOND EZELI |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: | 391528 |
Most Important Dates
| Enumeration Date: | 08/19/2019 |
| Last Updated: | 08/19/2019 |
Provider Practice Location
1825 SOUTHCROSS DR W APT 2303
BURNSVILLE
MN
553067976
Practice Location Phone/Fax
| Phone: | 6512639543 |
| Fax: |
Provider Mailing Location
1825 SOUTHCROSS DR W APT 2303
BURNSVILLE
MN
553067976
Provider Mailing Phone/Fax
| Phone: | 6512639543 |
| Fax: |