Healthcare Provider Details

I. General information

NPI: 1639821184
Provider Name (Legal Business Name): SAEED SAEED RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 NORMANDALE LAKE BLVD STE 978
BLOOMINGTON MN
55437-1085
US

IV. Provider business mailing address

8400 NORMANDALE LAKE BLVD STE 978
BLOOMINGTON MN
55437-1085
US

V. Phone/Fax

Practice location:
  • Phone: 612-217-2330
  • Fax:
Mailing address:
  • Phone: 612-217-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2479122
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: