MEDICARE: AKHMIRI SEKHR-RA B.A.

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1568866283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKHMIRI SEKHR-RA B.A.

Provider Business Mailing Address
First Line	:	2025 PORTLAND AVE
Second Line	:	C/O CULTURAL WELLNESS CENTER
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2654
Country	:	US
Telephone Number	:	612-721-5745
Fax Number	:	612-724-5461

Provider Business Practice Location Address
First Line	:	2025 PORTLAND AVE
Second Line	:	C/O CULTURAL WELLNESS CENTER
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2654
Country	:	US
Telephone Number	:	612-721-5745
Fax Number	:	612-724-5461

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2014
Last Update Date	:	10/09/2014

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