Provider Demographics
NPI:1811572704
Name:ISSE, SAID
Entity Type:Individual
Prefix:
First Name:SAID
Middle Name:
Last Name:ISSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 SMITH CIR
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2118
Mailing Address - Country:US
Mailing Address - Phone:952-303-5973
Mailing Address - Fax:952-843-5643
Practice Address - Street 1:1921 SMITH CIR
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2118
Practice Address - Country:US
Practice Address - Phone:952-303-5973
Practice Address - Fax:952-843-5643
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN396369163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health