817 Marshall Ave
NPI #1013140805 in Saint Paul, Minnesota
Provider Information
- NPI Number
- 1013140805
- Entity Type
- Organization
- Organization Name
- 817 Marshall Ave
- Primary Specialty
- Nursing Care
- Enumeration Date
- Aug 27, 2009
- Last Updated
- Aug 27, 2009
Practice Location
- Address
- 817 MARSHALL AVE
- City
- Saint Paul
- State
- Minnesota
- ZIP Code
- 55104-6651
- Phone
- (763) 202-8808
Authorized Official
- Name
- MRS. CHANNA ROXANNE PITTMAN, RN
- Title
- PRIVTE DUTY NURSE
- Phone
- (763) 202-8808
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nursing Care |
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