Provider Demographics
NPI:1023800760
Name:NURIE, ABDULLATIF
Entity type:Individual
Prefix:
First Name:ABDULLATIF
Middle Name:
Last Name:NURIE
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 1:6520 EDENVALE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2564
Mailing Address - Country:US
Mailing Address - Phone:612-261-9312
Mailing Address - Fax:612-500-4700
Practice Address - Street 1:6520 EDENVALE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2564
Practice Address - Country:US
Practice Address - Phone:612-261-9312
Practice Address - Fax:612-500-4700
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst