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General NPI Number Information
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NPI Number | 1588597892
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Entity Type | Individual
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Provider Name | IFRAH MOHAMUD NUR APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 625 HAYWARD AVE N
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City | OAKDALE
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State | MN
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Zip | 55128-7127
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Country | US
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Telephone | 612-800-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 8051 33RD AVE S UNIT 636
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-5018
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Country | US
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Telephone | 612-800-2156
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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 | 14312
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License Number State | MN
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