Individual provider · NPI-1

Makavie J Kanneh

Case Manager/Care Coordinator · Brooklyn Park, MN

NPI number1750044533
StatusActive
Last updated in NPPESFeb 2, 2023

Details

NPI
1750044533
Entity type
Individual (NPI-1)
Name
Makavie J Kanneh
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 18, 2021
Certification date
Feb 2, 2023
Last updated
Feb 2, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator–MNYes

Practice location

6350 67th Ave N
Brooklyn Park, MN 55428-2466

Phone 267-575-1473

Mailing address

6350 67th Ave N
Brooklyn Park, MN 55428-2466

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