Provider Demographics
NPI:1215618434
Name:PAJIBO, JOWO NDEBE (RN)
Entity type:Individual
Prefix:
First Name:JOWO
Middle Name:NDEBE
Last Name:PAJIBO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 KADLER AVE NE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55341-4512
Mailing Address - Country:US
Mailing Address - Phone:651-332-6519
Mailing Address - Fax:
Practice Address - Street 1:855 KADLER AVE NE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MN
Practice Address - Zip Code:55341-4512
Practice Address - Country:US
Practice Address - Phone:651-332-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2467579163WH0200X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice