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NPI Code Detail

MEDICARE: ROSANE MBOLI TAWAH RN

MEDICARE: ROSANE MBOLI TAWAH RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR202688-8MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1868K1CAOTHERMNBCBS

General Provider Information

NPI Number : 1033492210
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSANE MBOLI TAWAH RN
Provider Business Mailing Address
First Line : 555 CEDAR ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-2209
Country : US
Telephone Number : 651-266-1343
Fax Number :
Provider Business Practice Location Address
First Line : 1 VETERANS DR
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-2309
Country : US
Telephone Number : 612-725-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 03/23/2026

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