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General NPI Number Information
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NPI Number | 1255119087
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Entity Type | Individual
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Provider Name | FARTUN AHMED KEYNAN FNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 856 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-4807
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Country | US
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Telephone | 651-665-9795
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Fax | 651-665-9796
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Provider Business Mailing Address
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Address Line | 425 20TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-4400
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Country | US
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Telephone | 612-332-4973
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9850
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 2441926
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License Number State | MN
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