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NPI Code Detail

MEDICARE: FATOUMATTA NDONG

MEDICARE: FATOUMATTA NDONG
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 Nurse2510985MN

General Provider Information

NPI Number : 1295691236
Entity Type Code : Individual
Provider Name (Legal Business Name) : FATOUMATTA NDONG
Provider Business Mailing Address
First Line : 10400 BREN RD E
Second Line :
City : HOPKINS
State : MN
Zip : 55343-9055
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-245-2955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2026
Last Update Date : 01/07/2026

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Directions to “ FATOUMATTA NDONG ” Practice Location

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