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General NPI Number Information
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NPI Number | 1538045075
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Entity Type | Individual
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Provider Name | AZIETA NEJATI-NAMIN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 14551 COUNTY ROAD 11 STE 100
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City | BURNSVILLE
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State | MN
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Zip | 55337-4799
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Country | US
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Telephone | 952-841-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 15595 EARLY BIRD CIR
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7848
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2479831
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1116840-30
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06251854
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License Number State | MN
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