Healthcare Provider Details

I. General information

NPI: 1225949696
Provider Name (Legal Business Name): ABDIRAHMAN ADAN HUSSEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 S VAUGHN WAY STE 550
AURORA CO
80014-3538
US

IV. Provider business mailing address

3190 S VAUGHN WAY STE 550
AURORA CO
80014-3538
US

V. Phone/Fax

Practice location:
  • Phone: 701-213-3961
  • Fax:
Mailing address:
  • Phone: 701-213-3961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number04OPYA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: