Healthcare Provider Details

I. General information

NPI: 1760241335
Provider Name (Legal Business Name): DELPHINE NAYAH-CHUO TIMTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SMITH AVE N
SAINT PAUL MN
55102-2344
US

IV. Provider business mailing address

105 CARMEL AVE W APT 311
WEST SAINT PAUL MN
55118-3327
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-8000
  • Fax:
Mailing address:
  • Phone: 651-274-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number10237
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: