Provider Demographics
NPI:1194531855
Name:KUMI, SANDRA AFRIYIE (APRN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:AFRIYIE
Last Name:KUMI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 KALLAND CIR NE
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55301-4655
Mailing Address - Country:US
Mailing Address - Phone:612-272-8257
Mailing Address - Fax:
Practice Address - Street 1:16997 78TH PL N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-3761
Practice Address - Country:US
Practice Address - Phone:612-272-8257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12155363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health