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NPI Code Detail

MEDICARE: MUNA ADEN HASSAN

MEDICARE: MUNA ADEN HASSAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner13809MN
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1023756301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUNA ADEN HASSAN
Provider Business Mailing Address
First Line : 1919 BROADWAY ST NE STE 120
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1253
Country : US
Telephone Number : 612-323-1871
Fax Number : 612-656-0203
Provider Business Practice Location Address
First Line : 1919 BROADWAY ST NE STE 120
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1253
Country : US
Telephone Number : 612-323-1871
Fax Number : 612-656-0203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 01/14/2026

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