Provider Demographics
NPI:1689361628
Name:JIMALE, HODAN HASSAN
Entity Type:Individual
Prefix:
First Name:HODAN
Middle Name:HASSAN
Last Name:JIMALE
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 1:7021 WOODLAND DR APT 201
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2722
Mailing Address - Country:US
Mailing Address - Phone:952-693-7602
Mailing Address - Fax:
Practice Address - Street 1:7021 WOODLAND DR APT 201
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2722
Practice Address - Country:US
Practice Address - Phone:952-693-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker