Healthcare Provider Details

I. General information

NPI: 1982614178
Provider Name (Legal Business Name): NNENNA NWADIUTO DINNEY PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

8906 177TH ST W
LAKEVILLE MN
55044-6670
US

V. Phone/Fax

Practice location:
  • Phone: 612-467-2793
  • Fax: 612-467-2270
Mailing address:
  • Phone: 952-997-6109
  • Fax: 612-467-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number29286
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: