Most Relevant Information
Provider Data
| NPI Number: | 1003635434 |
| Provider Name: | MORIAH ROSE LELOU |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | L64298-9 |
Most Important Dates
| Enumeration Date: | 10/03/2024 |
| Last Updated: | 10/03/2024 |
Provider Practice Location
4801 VETERANS DR
SAINT CLOUD
MN
563032015
Practice Location Phone/Fax
| Phone: | 3202521670 |
| Fax: |
Provider Mailing Location
4801 VETERANS DRIVE
ST CLOUD
MN
56303
Provider Mailing Phone/Fax
| Phone: | 3202521670 |
| Fax: |