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NPI Code Detail

MEDICARE: AHMEDNUR ELMI AHMED

MEDICARE:   AHMEDNUR ELMI AHMED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1275376741
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMEDNUR ELMI AHMED
Provider Business Mailing Address
First Line : 1821 UNIVERSITY AVE W STE 169
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-2803
Country : US
Telephone Number : 651-421-1162
Fax Number :
Provider Business Practice Location Address
First Line : 29 7TH ST NE
Second Line :
City : ROCHESTER
State : MN
Zip : 55906-3644
Country : US
Telephone Number : 651-421-1162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2024
Last Update Date : 06/13/2024

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Directions to “ AHMEDNUR ELMI AHMED ” Practice Location

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