MEDICARE: AWLE ABDI HUSSEIN

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	146M00000X	Intermediate Emergency Medical Technician	H2500019746007	WI

General Provider Information

NPI Number	:	1518600832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AWLE ABDI HUSSEIN

Provider Business Mailing Address
First Line	:	3739 S PACKARD AVE APT 218
Second Line	:
City	:	ST FRANCIS
State	:	WI
Zip	:	53235-4325
Country	:	US
Telephone Number	:	702-888-6442
Fax Number	:

Provider Business Practice Location Address
First Line	:	3739 S PACKARD AVE APT 218
Second Line	:
City	:	ST FRANCIS
State	:	WI
Zip	:	53235-4325
Country	:	US
Telephone Number	:	702-888-6442
Fax Number	:

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

Provider Enumeration Date	:	04/14/2022
Last Update Date	:	04/14/2022

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Directions to “ AWLE ABDI HUSSEIN ” Practice Location

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