Healthcare Provider Details

I. General information

NPI: 1609783265
Provider Name (Legal Business Name): AMIRA AHMED MOHAMUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 JACKSON ST NE STE 100
MINNEAPOLIS MN
55413-3051
US

IV. Provider business mailing address

510 HEARTLAND DR
DELANO MN
55328-2304
US

V. Phone/Fax

Practice location:
  • Phone: 612-353-6293
  • Fax:
Mailing address:
  • Phone: 952-495-3189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberDOUL-423
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: