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Mrs. Mirabel Tibuji Mambo
Psychiatric/Mental Health Nurse Practitioner in Elk River, Minnesota
NPI 1639888092

Mirabel Tibuji Mambo is a Psychiatric/Mental Health Nurse Practitioner based in Elk River, MN and is specialized in Psychiatric/Mental Health. Mirabel Tibuji Mambo practices in Elk River, MN. The NPI Number for Mirabel Tibuji Mambo is 1639888092 and holds a License No. 9433 (Minnesota).

The current practice location address for Mirabel Tibuji Mambo is 19097 Baldwin St Nw, Elk River, MN and can be reached out via phone at 763-328-4738.

Location: 19097 Baldwin St Nw, Elk River, MN, 55330-2813
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639888092
Provider Name
Mirabel Tibuji Mambo
Credential
Provider Entity Type
Individual
Gender
Female
Address
19097 Baldwin St Nw, Elk River, MN, 55330-2813
Phone Number
763-328-4738
Fax Number
Provider Enumeration Date
11/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
19097 Baldwin St Nw
City
Elk River
State
Minnesota
Zip
55330-2813
Phone Number
763-328-4738
Fax Number
person
Provider Business Mailing Address Details
Address
19097 Baldwin St Nw
City
Elk River
State
Minnesota
Zip
55330-2813
Phone Number
763-328-4738
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
9433 (Minnesota)
Definition
Definition to come...
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