Provider Demographics
NPI:1831682822
Name:MADRIGAL ZUNIGA, JOSE MANUEL (RN)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:MADRIGAL ZUNIGA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 MINNEHAHA AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2341
Mailing Address - Country:US
Mailing Address - Phone:612-559-3005
Mailing Address - Fax:
Practice Address - Street 1:7360 GALLAGHER DR APT 301
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-3185
Practice Address - Country:US
Practice Address - Phone:612-559-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2465280163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse