Healthcare Provider Details

I. General information

NPI: 1285260497
Provider Name (Legal Business Name): YASMIN AHMED SULAYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 04/16/2020
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 KENOSHA DR NW
ROCHESTER MN
55901-5707
US

IV. Provider business mailing address

3433 KENOSHA DR NW
ROCHESTER MN
55901-5707
US

V. Phone/Fax

Practice location:
  • Phone: 507-202-7535
  • Fax:
Mailing address:
  • Phone: 507-202-7535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: