MEDICARE: REMI O ISELEWA APRN, PMHNP

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10087	MN

General Provider Information

NPI Number	:	1639864655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REMI O ISELEWA APRN, PMHNP

Provider Business Mailing Address
First Line	:	701 PARK AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1623
Country	:	US
Telephone Number	:	612-873-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	992 INWOOD AVE N
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-6625
Country	:	US
Telephone Number	:	612-842-9814
Fax Number	:	651-297-6414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2023
Last Update Date	:	02/16/2026

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