KHADRA MOHAMED RN NPI 1104276070

NPI Information

  • NPI: 1104276070
  • Provider Name: KHADRA MOHAMED, RN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2450 RIVERSIDE AVE
    MINNEAPOLIS, MN
    ZIP 55454
  • Phone: (612) 323-0538

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NPI Details

Khadra Mohamed, RN is a psychiatric/mental health nurse practitioner in Minneapolis, MN. Khadra Mohamed, RN NPI is 1104276070. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2450 RIVERSIDE AVE
MINNEAPOLIS, MN
ZIP 55454-450
Phone: (612) 323-0538

The NPI 1104276070 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2016 and was last updated on 10/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health10672MINNESOTAYes
2163WC1500XRegistered NurseCommunity HealthR-196969-0MINNESOTANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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