Healthcare Provider Details

I. General information

NPI: 1447115969
Provider Name (Legal Business Name): AASIYA SUMREEN MUJEEB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

20 6TH ST NE APT 427
MINNEAPOLIS MN
55413-1993
US

V. Phone/Fax

Practice location:
  • Phone: 309-363-5383
  • Fax:
Mailing address:
  • Phone: 309-363-5383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number126972
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: