Abdinasir K Ahmednoor

Individual provider Active NPI Community/Behavioral Health Agency · Eagan, MN

NPI 1801665104 · NPPES record last updated Dec 28, 2023

Key facts

NPI
1801665104
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
3906 Valley View Dr S Apt 302
Eagan, MN 55122-1562
Phone
(612) 987-6223
NPI assigned
Dec 28, 2023
Sex
Male
Sole proprietor
Yes

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
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

3906 Valley View Dr S Apt 302
Eagan, MN 55122-1562

Mailing address

3906 Valley View Dr S Apt 302
Eagan, MN 55122-1562
Phone (612) 987-6223

Other providers in Eagan, MN

All providers in Eagan, MN · Community/Behavioral Health Agency in Minnesota

Sources for this page

Verify at the official NPI Registry.