Provider Demographics
NPI:1902015563
Name:HER, TOUA
Entity Type:Individual
Prefix:
First Name:TOUA
Middle Name:
Last Name:HER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-1105
Mailing Address - Country:US
Mailing Address - Phone:651-442-3441
Mailing Address - Fax:
Practice Address - Street 1:1653 ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1105
Practice Address - Country:US
Practice Address - Phone:651-442-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant