Iftu Abdulla

Individual provider Active NPI Driver · Spring Lake Park, MN

NPI 1215664461 · NPPES record last updated Aug 6, 2022

Key facts

NPI
1215664461
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
Practice address
1600 81St Ave NE Apt 6
Spring Lake Park, MN 55432-1342
Phone
(763) 400-0851
NPI assigned
Aug 6, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X MN Yes

Addresses

Primary practice location

1600 81St Ave NE Apt 6
Spring Lake Park, MN 55432-1342

Mailing address

1600 81St Ave NE Apt 6
Spring Lake Park, MN 55432-1342
Phone (763) 400-0851

Other identifiers

IdentifierTypeStateIssuer
3826970OtherMNDOT

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Connecturl

Other providers in Spring Lake Park, MN

All providers in Spring Lake Park, MN · Driver in Minnesota

Sources for this page

Verify at the official NPI Registry.