Provider Demographics
NPI:1689316457
Name:SALEH, SUMAYA
Entity Type:Individual
Prefix:
First Name:SUMAYA
Middle Name:
Last Name:SALEH
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 1:6051 UNIVERSITY AVE NE APT 323
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2875
Mailing Address - Country:US
Mailing Address - Phone:612-998-0906
Mailing Address - Fax:
Practice Address - Street 1:6051 UNIVERSITY AVE NE APT 323
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-2875
Practice Address - Country:US
Practice Address - Phone:612-998-0906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2477096163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse