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Hussen Wako Butta

Home Health in Maplewood, MN. Individual provider (NPI-1).

NPI number1194356865
StatusActive
Last updated in NPPESJan 30, 2020

Details

NPI
1194356865
Entity type
Individual (NPI-1)
Name
Hussen Wako Butta
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 30, 2020
Certification date
Jan 30, 2020
Last updated
Jan 30, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health394663MNYes

Practice location

2245 Ide Ct
Maplewood, MN 55109-2635

Phone 612-578-7723

Mailing address

2245 Ide Ct
Maplewood, MN 55109-2635

Phone 612-578-7723

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