Individual
MUKTAR SHILLOW OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6200 SHINGLE CREEK PKWY STE 260, BROOKLYN CENTER, MN 55430-2128
(763) 544-0696
(763) 544-0984
Mailing address
12372 5TH ST NE, MINNEAPOLIS, MN 55434-2644
(612) 227-6750
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13976
MN
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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