Provider Demographics
NPI:1831806496
Name:MOHAMED, HAWA ABDIHAKIM (RN)
Entity type:Individual
Prefix:
First Name:HAWA
Middle Name:ABDIHAKIM
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:HAWA
Other - Middle Name:A
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:317 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PELICAN RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56572-4136
Mailing Address - Country:US
Mailing Address - Phone:763-218-3394
Mailing Address - Fax:
Practice Address - Street 1:317 RIVER RD
Practice Address - Street 2:
Practice Address - City:PELICAN RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56572-4136
Practice Address - Country:US
Practice Address - Phone:763-218-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN409567163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty