Individual
FATUMA A OSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
1600 68TH AVE NE, FRIDLEY, MN 55432-4717
(651) 500-9304
Mailing address
1600 68TH AVE NE, FRIDLEY, MN 55432-4717
(651) 500-9304
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A777918200
—
MN
Enumeration date
04/11/2022
Last updated
06/23/2022
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