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NPI Code Detail

MEDICARE: UNKNOWN OJONG AYAMBA AKAT

MEDICARE: UNKNOWN OJONG AYAMBA AKAT
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 Nurse2496848MN
2363LP2300XPrimary Care Nurse Practitioner12903MN

General Provider Information

NPI Number : 1487460382
Entity Type Code : Individual
Provider Name (Legal Business Name) : UNKNOWN OJONG AYAMBA AKAT
Provider Business Mailing Address
First Line : 2626 E 82ND ST STE 180
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55425-4503
Country : US
Telephone Number : 952-814-7400
Fax Number : 952-853-0966
Provider Business Practice Location Address
First Line : 1639 COUNTY ROAD C W
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1302
Country : US
Telephone Number : 651-796-3818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 03/16/2026

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Directions to “ UNKNOWN OJONG AYAMBA AKAT ” Practice Location

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