Provider Demographics
NPI:1578380861
Name:NUR, HAWO MOHAMUD (FNP)
Entity type:Individual
Prefix:
First Name:HAWO
Middle Name:MOHAMUD
Last Name:NUR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 DAYTONA AVENUE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ON
Mailing Address - Zip Code:N9B 3V7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7542 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1690
Practice Address - Country:US
Practice Address - Phone:313-415-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704350023363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care