Provider Demographics
NPI:1265000772
Name:ABDI, FAISAL KADAR (CNP)
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:KADAR
Last Name:ABDI
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12312 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-1982
Mailing Address - Country:US
Mailing Address - Phone:763-300-9128
Mailing Address - Fax:
Practice Address - Street 1:12312 3RD ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-1982
Practice Address - Country:US
Practice Address - Phone:763-300-9128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8218363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health