MEDICARE: FAISA HASSAN ABDI-OMAR CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	2292324	MN
2	163WG0000X	General Practice Registered Nurse	2292324	MN
3	163WH0200X	Home Health Registered Nurse	2292324	MN
4	163WL0100X	Lactation Consultant (Registered Nurse)	2292324	MN
5	163WM0102X	Maternal Newborn Registered Nurse	2292324	MN
6	163WN1003X	Nutrition Support Registered Nurse	2292324	MN
7	163WP1700X	Perinatal Registered Nurse	2292324	MN
8	163WW0000X	Wound Care Registered Nurse	2292324	MN
9	163WW0101X	Ambulatory Women's Health Care Registered Nurse	2292324	MN
10	176B00000X	Midwife	405	MN

General Provider Information

NPI Number	:	1467006700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAISA HASSAN ABDI-OMAR CNM

Provider Business Mailing Address
First Line	:	7538 OCHOA AVE NE
Second Line	:
City	:	OTSEGO
State	:	MN
Zip	:	55330-6888
Country	:	US
Telephone Number	:	612-814-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	941 HILLWIND RD NE STE 302
Second Line	:
City	:	FRIDLEY
State	:	MN
Zip	:	55432-5965
Country	:	US
Telephone Number	:	612-814-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2019
Last Update Date	:	08/14/2025

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