Provider Demographics
NPI:1184184863
Name:ABDIKADIR, HAFSA M (NP)
Entity Type:Individual
Prefix:
First Name:HAFSA
Middle Name:M
Last Name:ABDIKADIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 E TRAVERSEPOINT DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5679
Mailing Address - Country:US
Mailing Address - Phone:801-553-8300
Mailing Address - Fax:801-553-8301
Practice Address - Street 1:267 E TRAVERSEPOINT DR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5679
Practice Address - Country:US
Practice Address - Phone:801-553-8300
Practice Address - Fax:801-553-8301
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7604047-4405363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care