Provider Demographics
NPI:1356000699
Name:ABUBAKAR-ELMEHRA, HAMZA
Entity Type:Individual
Prefix:
First Name:HAMZA
Middle Name:
Last Name:ABUBAKAR-ELMEHRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE N188
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2870
Mailing Address - Country:US
Mailing Address - Phone:952-221-0729
Mailing Address - Fax:651-927-0199
Practice Address - Street 1:1821 UNIVERSITY AVE W STE N188
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2870
Practice Address - Country:US
Practice Address - Phone:952-221-0729
Practice Address - Fax:651-927-0199
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN939699800037163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty