Provider Demographics
NPI:1366080681
Name:ABOAGYE, RHODALINE ABA TAKYIWAA (CNP)
Entity type:Individual
Prefix:
First Name:RHODALINE
Middle Name:ABA TAKYIWAA
Last Name:ABOAGYE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7370 LANDAU DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-2308
Mailing Address - Country:US
Mailing Address - Phone:612-387-2786
Mailing Address - Fax:
Practice Address - Street 1:2355 HIGHWAY 36 W
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3902
Practice Address - Country:US
Practice Address - Phone:763-412-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily