Provider Demographics
NPI:1104580869
Name:ABDI, HAFSA (RN)
Entity type:Individual
Prefix:
First Name:HAFSA
Middle Name:
Last Name:ABDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 SPRING HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-1332
Mailing Address - Country:US
Mailing Address - Phone:404-754-4908
Mailing Address - Fax:
Practice Address - Street 1:1573 SPRING HOLLOW WAY
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-1332
Practice Address - Country:US
Practice Address - Phone:404-754-4908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN300802163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse