Provider Demographics
NPI:1508331315
Name:DAHIR, SIRAD AHMED (RN)
Entity Type:Individual
Prefix:
First Name:SIRAD
Middle Name:AHMED
Last Name:DAHIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 E 24TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3927
Mailing Address - Country:US
Mailing Address - Phone:612-721-4003
Mailing Address - Fax:
Practice Address - Street 1:1305 E 24TH ST STE 2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3927
Practice Address - Country:US
Practice Address - Phone:612-721-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2388348163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse