Provider Demographics
NPI:1992300370
Name:AHMED, SAFIYA N
Entity type:Individual
Prefix:
First Name:SAFIYA
Middle Name:N
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 DOROTHY DAY PL
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1081
Mailing Address - Country:US
Mailing Address - Phone:651-290-6815
Mailing Address - Fax:651-290-6818
Practice Address - Street 1:438 DOROTHY DAY PL
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1081
Practice Address - Country:US
Practice Address - Phone:651-290-6815
Practice Address - Fax:651-290-6818
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily