Healthcare Provider Details

I. General information

NPI: 1306765565
Provider Name (Legal Business Name): NOMAN AHMAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 LYNDALE AVE S STE 101J
BLOOMINGTON MN
55420-2734
US

IV. Provider business mailing address

8609 LYNDALE AVE S STE 101J
BLOOMINGTON MN
55420-2734
US

V. Phone/Fax

Practice location:
  • Phone: 651-317-4540
  • Fax:
Mailing address:
  • Phone: 651-317-4540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: