Provider Demographics
NPI:1578392445
Name:BADE, UBAH ABDULLAHI (DIR ADV CERTIFICATE)
Entity type:Individual
Prefix:
First Name:UBAH
Middle Name:ABDULLAHI
Last Name:BADE
Suffix:
Gender:F
Credentials:DIR ADV CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-1717
Mailing Address - Country:US
Mailing Address - Phone:763-358-0403
Mailing Address - Fax:
Practice Address - Street 1:720 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1717
Practice Address - Country:US
Practice Address - Phone:612-607-3967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1875849163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse