MEDICARE: NOOR TELEMED CLINIC LLC

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1407798556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOOR TELEMED CLINIC LLC

Provider Business Mailing Address
First Line	:	2909 WAYZATA BLVD STE 43128
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2126
Country	:	US
Telephone Number	:	206-330-8439
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 WAYZATA BLVD STE 43128
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2126
Country	:	US
Telephone Number	:	206-330-8439
Fax Number	:

Authorized Official
Title or Position	:	ARNP, FNP-C
Name	:	HAMDI M ABDI
Credential	:	DNP
Telephone Number	:	206-330-8439

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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