Healthcare Provider Details

I. General information

NPI: 1194653022
Provider Name (Legal Business Name): FARHIYA A MOHAMUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14203 ADALYN AVE APT 222
ROSEMOUNT MN
55068-4878
US

IV. Provider business mailing address

14203 ADALYN AVE APT 222
ROSEMOUNT MN
55068-4878
US

V. Phone/Fax

Practice location:
  • Phone: 952-210-8880
  • Fax:
Mailing address:
  • Phone: 952-210-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number10865890
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: