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General NPI Number Information
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NPI Number | 1396652350
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Entity Type | Individual
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Provider Name | ABDIRIZAK MOHAMED ALI DNP, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 166 4TH ST E STE 200
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City | SAINT PAUL
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State | MN
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Zip | 55101-1667
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Country | US
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Telephone | 651-361-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 729 EDGERTON ST
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City | SAINT PAUL
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State | MN
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Zip | 55130-4116
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Country | US
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Telephone | 651-361-0035
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 14620
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License Number State | MN
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