Fatuma A Osman, OWNER
Individual provider Active NPI Homemaker · Fridley, MN
NPI 1811639719 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1811639719
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 1600 68TH Ave NE
Fridley, MN 55432-4717 - Phone
- (651) 500-9304
- NPI assigned
- Apr 11, 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Yes |
Addresses
Primary practice location
1600 68TH Ave NE
Fridley, MN 55432-4717
Mailing address
1600 68TH Ave NE
Fridley, MN 55432-4717
Phone (651) 500-9304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A777918200 | Medicaid | MN |
Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.