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General NPI Number Information
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NPI Number | 1295454874
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Entity Type | Organization
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Legal Business Name | ECLIPSE HEALTH SERVICES
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 2529 132ND LN NW
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City | COON RAPIDS
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State | MN
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Zip | 55448-1205
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Country | US
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Telephone | 763-298-3159
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Fax |
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Provider Business Mailing Address
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Address Line | 2529 132ND LN NW
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City | COON RAPIDS
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State | MN
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Zip | 55448-1205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ZILLAH K MULUBISHA
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Credential | DNP/AGNP/CPN
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Telephone | 763-298-3159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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