Mrs. Mirabel Tibuji Mambo
Mrs. Mirabel Tibuji Mambo is a Nurse Practitioner in Elk River, Minnesota. Qualified in 2022, 4 years ago. Practices with Diamond Lake Clinic, PC, a 12-clinician group and accepts Medicare assignment. Licensed in Minnesota.
- Years since qualifying
- 4
- Licensed in
- MN
- In the registry since
- 2022
Practice location Address checks out
19097 Baldwin St NWElk River, MN 55330-2813
Phone: (763) 328-4738
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence 9433 (MN) |
|---|
Record details
| NPI number | 1639888092 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | November 15, 2022 |
| Last updated in NPPES | November 15, 2022 |
| Certification date | November 15, 2022 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Group practice | Diamond Lake Clinic, P.C. — 12 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Elk River
-
Gladys Ndike, CNP
9974 190th Ave NW, Elk River, MN 55330-2459 · (651) 815-8185
-
Ornate Mental Health Services LLC
9913 Twin Lakes Pkwy NW, Elk River, MN 55330-3221 · (651) 357-7824
-
Mrs. Perkaloah Amanda Queeglay-Tarpeh, RN
19485 Boston St NW, Elk River, MN 55330-4121 · (612) 695-4971