Provider Demographics
NPI:1184021198
Name:ASZANI STODDARD, LLC
Entity Type:Organization
Organization Name:ASZANI STODDARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASZANI
Authorized Official - Middle Name:
Authorized Official - Last Name:STODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:APNP, CNM, MSN
Authorized Official - Phone:612-356-4072
Mailing Address - Street 1:3605 40TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2846
Mailing Address - Country:US
Mailing Address - Phone:612-356-4072
Mailing Address - Fax:612-392-0118
Practice Address - Street 1:970 RAYMOND AVE
Practice Address - Street 2:SUITE G-10
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1146
Practice Address - Country:US
Practice Address - Phone:612-356-4072
Practice Address - Fax:612-392-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Single Specialty