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NPI Code Detail

MEDICARE: SEBLE MELSE LEMMA

MEDICARE: SEBLE MELSE LEMMA
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 Nurse1775994MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215661251
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEBLE MELSE LEMMA
Provider Business Mailing Address
First Line : 1627 WHITE BEAR AVE N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-1609
Country : US
Telephone Number : 651-278-7319
Fax Number :
Provider Business Practice Location Address
First Line : 1627 WHITE BEAR AVE N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-1609
Country : US
Telephone Number : 651-278-7319
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2022
Last Update Date : 07/14/2022

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Directions to “ SEBLE MELSE LEMMA ” Practice Location

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