Provider Demographics
NPI:1003475690
Name:HASSAN, MILGO (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:MILGO
Middle Name:
Last Name:HASSAN
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 S GREAT SOUTHWEST PKWY APT 537
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7393
Mailing Address - Country:US
Mailing Address - Phone:817-983-4481
Mailing Address - Fax:
Practice Address - Street 1:303 E NICOLLET BLVD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4522
Practice Address - Country:US
Practice Address - Phone:952-892-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN235467-3163WC0200X
MN617364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN235467-3OtherMINNESOTA BOARD OF NURSING