Provider Demographics
NPI:1114728854
Name:SHEIKHNOOR, FARDOWSA
Entity type:Individual
Prefix:
First Name:FARDOWSA
Middle Name:
Last Name:SHEIKHNOOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 OLD CEDAR AVE S STE 227B
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1203
Mailing Address - Country:US
Mailing Address - Phone:612-404-4691
Mailing Address - Fax:
Practice Address - Street 1:10967 UNIVERSITY AVE NE APT E
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-1993
Practice Address - Country:US
Practice Address - Phone:612-404-4691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health