Provider Demographics
NPI:1902462161
Name:EKLOU, GEORGES DOH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:GEORGES
Middle Name:DOH
Last Name:EKLOU
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 E FRANKLIN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2101
Mailing Address - Country:US
Mailing Address - Phone:612-343-4004
Mailing Address - Fax:612-343-4007
Practice Address - Street 1:1433 E FRANKLIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2101
Practice Address - Country:US
Practice Address - Phone:612-343-4004
Practice Address - Fax:612-343-4007
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2425780OtherMN BOARD OF NURSING