Healthcare Provider Details

I. General information

NPI: 1730832296
Provider Name (Legal Business Name): NIMO AHMED APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 E LAKE ST STE 500
MINNEAPOLIS MN
55407-4385
US

IV. Provider business mailing address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-6963
  • Fax: 612-276-0188
Mailing address:
  • Phone: 612-873-3000
  • Fax: 612-873-1928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number497
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: