MEDICARE: KEDIJA YAHYA NURU

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	343800000X	Secured Medical Transport (VAN)
2	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1770236846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEDIJA YAHYA NURU

Provider Business Mailing Address
First Line	:	1733 ARIAL DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-7340
Country	:	US
Telephone Number	:	512-554-1745
Fax Number	:

Provider Business Practice Location Address
First Line	:	1733 ARIAL DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-7340
Country	:	US
Telephone Number	:	512-554-1745
Fax Number	:

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

Provider Enumeration Date	:	01/30/2022
Last Update Date	:	09/21/2022

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Directions to “ KEDIJA YAHYA NURU ” Practice Location

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