Provider Demographics
NPI:1568000719
Name:NOOR, FATUSH ABDIKAFI
Entity Type:Individual
Prefix:
First Name:FATUSH
Middle Name:ABDIKAFI
Last Name:NOOR
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 1:2622 GERSHWIN AVE N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-3542
Mailing Address - Country:US
Mailing Address - Phone:612-707-9776
Mailing Address - Fax:
Practice Address - Street 1:2622 GERSHWIN AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-3542
Practice Address - Country:US
Practice Address - Phone:612-707-9776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health