Provider Demographics
NPI:1215528344
Name:NAS HEALTHCARE CENTER
Entity type:Organization
Organization Name:NAS HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ALADE
Authorized Official - Middle Name:LATEEF
Authorized Official - Last Name:HAMZA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:763-477-8151
Mailing Address - Street 1:PO BOX 431114
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-7225
Mailing Address - Country:US
Mailing Address - Phone:763-477-8151
Mailing Address - Fax:
Practice Address - Street 1:10907 XYLON LN N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3712
Practice Address - Country:US
Practice Address - Phone:763-477-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty