Provider Demographics
NPI:1912321092
Name:VUE, MAIKIA
Entity Type:Individual
Prefix:
First Name:MAIKIA
Middle Name:
Last Name:VUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 BROOKLYN BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2517
Mailing Address - Country:US
Mailing Address - Phone:763-205-9965
Mailing Address - Fax:763-710-9178
Practice Address - Street 1:5901 BROOKLYN BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55429-2517
Practice Address - Country:US
Practice Address - Phone:763-205-9965
Practice Address - Fax:763-710-9178
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist