Individual
FADUMO HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8450 SEASONS PARKWAY, WOODBURY, MN 55125-4402
(651) 702-5300
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
2212715
MN
363L00000X
Nurse Practitioner
Primary
11938
MN
Other
Enumeration date
09/11/2020
Last updated
09/19/2024
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