Provider Demographics
NPI:1437936713
Name:BILLE, ABDIRIZAK M
Entity Type:Individual
Prefix:
First Name:ABDIRIZAK
Middle Name:M
Last Name:BILLE
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 1:1403 SILVER LAKE RD NW STE 5
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-9310
Mailing Address - Country:US
Mailing Address - Phone:176-332-7478
Mailing Address - Fax:
Practice Address - Street 1:1403 SILVER LAKE RD NW STE 5
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-9310
Practice Address - Country:US
Practice Address - Phone:176-332-7478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide