Healthcare Provider Details

I. General information

NPI: 1003475690
Provider Name (Legal Business Name): MILGO HASSAN APRN, CNP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 XERXES AVE S
EDINA MN
55423-1033
US

IV. Provider business mailing address

15899 ELMHURST LN UNIT 7202
APPLE VALLEY MN
55124-4023
US

V. Phone/Fax

Practice location:
  • Phone: 952-925-8500
  • Fax:
Mailing address:
  • Phone: 817-983-4481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number235467-3
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number617
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13456
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: