Healthcare Provider Details

I. General information

NPI: 1487501185
Provider Name (Legal Business Name): EMMANUEL OPOKU FRIMPONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6415 ALVARADO LN N
MAPLE GROVE MN
55311-2268
US

IV. Provider business mailing address

6415 ALVARADO LN N
MAPLE GROVE MN
55311-2268
US

V. Phone/Fax

Practice location:
  • Phone: 612-458-5745
  • Fax:
Mailing address:
  • Phone: 612-458-5745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number2241870
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: