Healthcare Provider Details

I. General information

NPI: 1689858557
Provider Name (Legal Business Name): CHINWE EKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11230 86TH AVE N
MAPLE GROVE MN
55369-4510
US

IV. Provider business mailing address

6454 APPALOOSA AVE S
FOREST LAKE MN
55025-9246
US

V. Phone/Fax

Practice location:
  • Phone: 763-272-5432
  • Fax:
Mailing address:
  • Phone: 201-838-0573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number6128
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6128
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: