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NPI Code Detail

MEDICARE: MRS. NANCY NYABUTI

MEDICARE: MRS. NANCY NYABUTI
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
1101YP2500XProfessional Counselor5548MN

General Provider Information

NPI Number : 1407677909
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY NYABUTI
Provider Business Mailing Address
First Line : 7960 ORCHID LN N
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55311-2186
Country : US
Telephone Number : 612-807-0456
Fax Number :
Provider Business Practice Location Address
First Line : 13603 80TH CIR N
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-8961
Country : US
Telephone Number : 763-274-3120
Fax Number : 763-274-3121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2024
Last Update Date : 04/23/2026

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Directions to “ MRS. NANCY NYABUTI ” Practice Location

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