Provider Demographics
NPI:1063109445
Name:MOHAMED, KIIN HUSSEIN (RN)
Entity type:Individual
Prefix:
First Name:KIIN
Middle Name:HUSSEIN
Last Name:MOHAMED
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8200 HUMBOLDT AVE S APT 423
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2261
Mailing Address - Country:US
Mailing Address - Phone:614-558-7391
Mailing Address - Fax:
Practice Address - Street 1:2550 UNIVERSITY AVE W STE 130N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1096
Practice Address - Country:US
Practice Address - Phone:651-447-3755
Practice Address - Fax:651-444-8923
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH0036400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily