Provider Demographics
NPI:1205635141
Name:OGUNNIRAN, SESAN L (RN)
Entity type:Individual
Prefix:
First Name:SESAN
Middle Name:L
Last Name:OGUNNIRAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18927 100TH PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-2270
Mailing Address - Country:US
Mailing Address - Phone:612-501-4029
Mailing Address - Fax:612-501-4029
Practice Address - Street 1:6500 BROOKLYN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1755
Practice Address - Country:US
Practice Address - Phone:612-886-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2086187163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health