Provider Demographics
NPI:1063158806
Name:LANSANA, JOSEPHINE SOWIE
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:SOWIE
Last Name:LANSANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20919 CARVER ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-4018
Mailing Address - Country:US
Mailing Address - Phone:952-452-1031
Mailing Address - Fax:
Practice Address - Street 1:20919 CARVER ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-4018
Practice Address - Country:US
Practice Address - Phone:952-452-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2465290163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical