Provider Demographics
NPI:1326767872
Name:NYAMAO, JULIUS MIRANYI (DNP APRN FNP)
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:MIRANYI
Last Name:NYAMAO
Suffix:
Gender:M
Credentials:DNP APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:6350 W 143RD ST STE 200
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2890
Practice Address - Country:US
Practice Address - Phone:952-428-1010
Practice Address - Fax:952-428-1005
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9448363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN9448OtherNURSE PRACTITIONER LICENCE