Healthcare Provider Details

I. General information

NPI: 1669073029
Provider Name (Legal Business Name): BABATUNDE SAFIRIYU ADAMS CNS, CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 MINNESOTA DR STE 170
BLOOMINGTON MN
55435-5202
US

IV. Provider business mailing address

13543 CARLINGFORD WAY
ROSEMOUNT MN
55068-6306
US

V. Phone/Fax

Practice location:
  • Phone: 612-915-0049
  • Fax:
Mailing address:
  • Phone: 651-468-8756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number547
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11078
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: