Provider Demographics
NPI:1962006908
Name:AHMED, NURADIN ABUBAKAR
Entity Type:Individual
Prefix:
First Name:NURADIN
Middle Name:ABUBAKAR
Last Name:AHMED
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 1:8112 WENTWORTH AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-1109
Mailing Address - Country:US
Mailing Address - Phone:612-269-1495
Mailing Address - Fax:
Practice Address - Street 1:8112 WENTWORTH AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-1109
Practice Address - Country:US
Practice Address - Phone:612-269-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide