Healthcare Provider Details

I. General information

NPI: 1255064242
Provider Name (Legal Business Name): NAJMA ABDI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 DELAWARE ST SE
MINNEAPOLIS MN
55455-0356
US

IV. Provider business mailing address

516 DELAWARE ST SE
MINNEAPOLIS MN
55455-0356
US

V. Phone/Fax

Practice location:
  • Phone: 612-625-7950
  • Fax:
Mailing address:
  • Phone: 612-625-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15099
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: