Provider Demographics
NPI:1508512120
Name:MUHUMED, FARTUN AHMED
Entity type:Individual
Prefix:
First Name:FARTUN
Middle Name:AHMED
Last Name:MUHUMED
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 1:2126 VINING DR UNIT E
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-7580
Mailing Address - Country:US
Mailing Address - Phone:701-412-4404
Mailing Address - Fax:
Practice Address - Street 1:2126 VINING DR UNIT E
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-7580
Practice Address - Country:US
Practice Address - Phone:701-412-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR37570163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse