Momodou Manjang Jr.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

516682 Issued in WI

Practice address

6252 Creekview LN N
Brooklyn Park, MN 55443-2374

Phone

(612) 483-4178

NPI assigned

Oct 4, 2025

Sex

Unspecified or another gender identity

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1548134182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6252 CREEKVIEW LN N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432374",
            "telephone_number": "612-483-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6252 CREEKVIEW LN N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432374",
            "telephone_number": "612-483-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJANG",
        "first_name": "MOMODOU",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-10-04",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "516682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.