Provider Demographics
NPI:1114708310
Name:ALI, HAFSA MOHAMED
Entity type:Individual
Prefix:
First Name:HAFSA
Middle Name:MOHAMED
Last Name:ALI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KHADIJA
Other - Middle Name:MOHAMMED
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2301 CALIFORNIA ST NE APT 417
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3397
Mailing Address - Country:US
Mailing Address - Phone:763-346-1278
Mailing Address - Fax:
Practice Address - Street 1:9340 JAMES AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2317
Practice Address - Country:US
Practice Address - Phone:612-226-0907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1559694500024343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)