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General NPI Number Information
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NPI Number | 1164194106
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Entity Type | Organization
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Legal Business Name | NURA MOBILE MEDICINE LLC
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 01/04/2022
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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 |
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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 |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | NIMO ABDI
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Credential | DOCTOR OF NURSING
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Telephone | 612-226-2747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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