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General NPI Number Information
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NPI Number | 1114477858
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Entity Type | Individual
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Provider Name | NIMO SALEBAN ABDI
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Gender | Female
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 10067 GRISTMILL RDG
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-4761
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Country | US
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Telephone | 612-226-2747
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Fax | 612-465-4884
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Provider Business Mailing Address
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Address Line | 10067 GRISTMILL RDG
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-4761
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Country | US
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Telephone | 612-226-2747
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Fax | 612-465-4884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP 4835
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License Number State | MN
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