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General NPI Number Information
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NPI Number | 1114728854
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Entity Type | Individual
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Provider Name | FARDOWSA SHEIKHNOOR
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 10967 UNIVERSITY AVE NE APT E
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City | BLAINE
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State | MN
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Zip | 55434-1993
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Country | US
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Telephone | 612-404-4691
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Fax |
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Provider Business Mailing Address
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Address Line | 8030 OLD CEDAR AVE S STE 227B
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1203
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Country | US
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Telephone | 612-404-4691
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Fax |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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