Healthcare Provider Details

I. General information

NPI: 1215846746
Provider Name (Legal Business Name): MOHAMMED RAMADAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15175 DESTINATION DR
NOBLESVILLE IN
46060-3856
US

IV. Provider business mailing address

15175 DESTINATION DR
NOBLESVILLE IN
46060-3856
US

V. Phone/Fax

Practice location:
  • Phone: 407-780-4068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number28255077A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: