Provider Demographics
NPI:1477328219
Name:OMAR, NASRO ABDIRAHMAN SHEIKH
Entity Type:Individual
Prefix:
First Name:NASRO
Middle Name:ABDIRAHMAN SHEIKH
Last Name:OMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 NICOLLET AVENUE S STE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403
Mailing Address - Country:US
Mailing Address - Phone:612-354-9956
Mailing Address - Fax:
Practice Address - Street 1:2614 NICOLLET AVE STE 209
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-1628
Practice Address - Country:US
Practice Address - Phone:612-354-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician