Provider Demographics
NPI:1184516866
Name:AMAN, ISA JEMAL
Entity type:Individual
Prefix:
First Name:ISA
Middle Name:JEMAL
Last Name:AMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 LILAC DR N # 251G2
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4535
Mailing Address - Country:US
Mailing Address - Phone:712-333-1490
Mailing Address - Fax:
Practice Address - Street 1:1405 LILAC DR N # 251G2
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4535
Practice Address - Country:US
Practice Address - Phone:712-333-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health