Provider Demographics
NPI:1891527990
Name:OSMAN, IMAN A
Entity type:Individual
Prefix:
First Name:IMAN
Middle Name:A
Last Name:OSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 HIGHWAY 7 APT 401
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2282
Mailing Address - Country:US
Mailing Address - Phone:507-341-0006
Mailing Address - Fax:
Practice Address - Street 1:122 W FRANKLIN AVE STE 323
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2452
Practice Address - Country:US
Practice Address - Phone:612-871-3759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker