Provider Demographics
NPI:1467006700
Name:ABDI-OMAR, FAISA HASSAN (CNM)
Entity Type:Individual
Prefix:
First Name:FAISA
Middle Name:HASSAN
Last Name:ABDI-OMAR
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7538 OCHOA AVE NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6888
Mailing Address - Country:US
Mailing Address - Phone:612-814-1800
Mailing Address - Fax:
Practice Address - Street 1:7538 OCHOA AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6888
Practice Address - Country:US
Practice Address - Phone:612-814-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2292324163WW0000X, 163WW0101X, 163WC1500X, 163WH0200X, 163WG0000X, 163WM0102X, 163WN1003X, 163WP1700X, 163WL0100X
MN405176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwife
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition SupportGroup - Multi-Specialty
No163WP1700XNursing Service ProvidersRegistered NursePerinatalGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty